Are you
available to work whatever schedule is necessary to help us meet our
Corporate objectives and our obligations to our clients?
Yes
No
If no, what
shifts are you available
Monday
AM
PM
Tuesday
AM
PM
Wednesday
AM
PM
Thursday
AM
PM
Friday
AM
PM
Saturday
AM
PM
Sunday
AM
PM
Are you
Presently Employed?
Yes
No
If yes, may we contact your present
employer
Yes
No
Can you make
it to work each day on time
Yes
No
Have you ever been
employed by WKC Restaurants or any other client company that you are
aware of?
Yes
No
If yes
Where
When
Position
Reason for leaving
Referral Source:
Names and Relationships of
relatives or acquaintances employed at WKC Restaurants
Have you ever been
convicted of, or pled guilty or "no contest" to, a misdemeanor, or
felony (do not include minor traffic infractions for which you never
appeared in court, offenses which were dismissed or discharged after
successful completion of probation, and convictions or pleas which have
been deemed sealed or exponged by law)?
Yes
No
If yes, give the details
concerning the type of crime, the date of the conviction or plea, the
penalty imposed, and any other circumstances you deem relevant to a full
understanding of what occured. (Factors such as age at the time of the
offense, seriousness and nature of the violation, relatedness to the job
sought, and evidence of rehabilitation will be taken into account.)
Have you ever been sued in
a civil action with regard to the death of or personal injury or
intentional damage to any person?
Yes
No
If yes, give the details
concerning the nature of the claims and defenses raised by the parties,
the outcome of the action(e.g., settlement, jury verdict, or other
disposition), and any other circumstances you deem relevant to a full
understanding of what occured.
Are you prevented from
being employed in this country because of Visa or Immigration status?
Yes
No
THE FOLLOWING INFORMATION WILL ONLY
BE CONSIDERED IF IT IS RELEVANT TO THE POSITION FOR WHICH YOU ARE
APPLYING OR COULD BEAR UPON STATE LICENSING REQUIREMENTS.
Do you use any
illegal drugs? (answer is optional)
THE FOLLOWING INFORMATION WILL BE
USED ONLY TO THE EXTENT THAT IS RELEVANT TO THE QUALIFICATIONS AND
POSITION FOR WHICH YOU APPLY
What is the highest grade
completed?
Do you have a high school diploma or GED?
Yes
No
Did you graduate from college?
Yes
No
If yes, name of College
Degree
List all employment, including
military, for the past 7 years beginning with your present job or last
job held.
From
To
Employer
Supervisor
Address
Telephone
Salary
Per
Position/Job Duties
Reason for Leaving
From
To
Employer
Supervisor
Address
Telephone
Salary
Per
Position/Job Duties
Reason for Leaving
From
To
Employer
Supervisor
Address
Telephone
Salary
Per
Position/Job Duties
Reason for Leaving
From
To
Employer
Supervisor
Address
Telephone
Salary
Per
Position/Job Duties
Reason for Leaving
From
To
Employer
Supervisor
Address
Telephone
Salary
Per
Position/Job Duties
Reason for Leaving
Have you ever
been dismissed or asked to resign from employment?
Yes
No
If Yes, Employer
Reason
Have you ever been granted
a military or government security clearance?
Yes
No
If Yes, level of clearance
List any special job
skills or qualifications that may be relevant to the position for which
you are applying.
References:
(5 persons not related to you and who are not former employers)
Name and occupation Address
Phone #
By clicking here you are
electronically signing that you
agree to the above statements: Yes
No