RuckerJohns Restaurants
Application For Employment




Date:__/ ___/____

Personal Information:

Name: ________________________________________________________
Address: ______________________________________________________
              ______________________________________________________
              ______________________________________________________

Phone #: (________) _________-____________

Date of Birth: ____________________________
SSN#: ___________________________________

Position Applied For: _____________________________________________
Date Available: _________________ Salary Desired: ____________________
Full Time: ____ Part Time: _____Days: _____Nights: _____ Weekends: ______

Are you presently employed:
Yes  or No  
If so may we contact your employer? Yes or No
Have you ever been convicted of a drug or alcohol related crime?
Yes   or   No

Education:


High School: ___________________________________
Starting Date: ___________________ Ending Date: ___________________
Years Attended: __________________________ Graduated?
Yes   or   No

College: ___________________________________
Starting Date: __________________ Ending Date: ___________________
Years Attended: __________________________ Graduated?
Yes   or   No
Areas of Study: _______________________________________________

Former Employers: (start with most recent)


Company: ____________________ Phone #: (_____) ______-_________
Date Started: __________________ Date Left: _____________________
Immediate Supervisor: _________________________________________
Position Held: _______________________________________________
Reason for Leaving: ___________________________________________

Company: ____________________ Phone #: (_____) ______-_________

Date Started: __________________ Date Left: _____________________
Immediate Supervisor: _________________________________________
Position Held: _______________________________________________
Reason for Leaving: ___________________________________________

Company: ____________________ Phone #: (_____) ______-_________

Date Started: __________________ Date Left: _____________________
Immediate Supervisor: _________________________________________
Position Held: _______________________________________________
Reason for Leaving: ___________________________________________

For Office Use Only: _________________________________________
          _____________________________________________________
          _____________________________________________________
          _____________________________________________________
          _____________________________________________________
          _____________________________________________________
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RuckerJohns Restaurants
An Equal Opportunity Employer