1 General Information2 Employment Information3 Education Information4 Desired Location*Emerald IsleWilmington Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of Birth* MM DD YYYY Have you ever been convicted of a crime/felony?*YesNoIf yes, please explain.Was the offense drug or alcohol related?YesNoIf it was drug or alcohol related, please explain.If hired, can you submit documents to prove your legal right to work in the U.S.?*YesNoWe do not permit smoking while on duty. Are you willing to comply?*YesNoRuckerJohns does not tolerate drug use by employees before or during work, or on RuckerJohns premises. Are you willing to comply?*YesNo Position applying for* Server Host/Hostess Kitchen Salary desiredDate available to start work* MM DD YYYY Availability* Full Time Part Time Days Nights Weekends Please check all that apply.Are you of legal age to serve alcoholic beverages (18 years or older)?*YesNoUp to 50 lbs. of lifting several times a day is an essential function of kitchen positions. Are you willing and able to comply?*YesNoBeing on your feet 6-9 hours at a time is a requirement in dining room positions. Are you willing and able to comply?*YesNoThird ChoiceRuckerJohns may train/have meetings on days you have other obligations. Are you willing to reschedule your plans to come to training/meetings?*YesNoIf offered a position with RuckerJohns, how long would you plan to remain with us?*We have specific requirements for personal appearance for both the dining room and kitchen: clean, proper work apparel, and good general hygiene. Are you willing to comply?*YesNoAre you presently employed?*YesNoPlace of current employmentMay we contact your present employer?YesNoList your previous employers (start with most recent)CompanyImmediate SupervisorPhonePosition heldDate startedDate leftReason for leavingCompanyImmediate SupervisorPhonePosition heldDate startedDate leftReason for leavingCompanyImmediate SupervisorPhonePosition heldDate startedDate leftReason for leavingAny other related experience? High School*Starting dateEnding DateGraduated?*YesNoCollege or UniversityStarting dateEnding DateGraduated?YesNoArea of StudyAffirmation of Information* I affirm that all information in this application is true and complete. Any misrepresentation, false statement, or omission of facts called for shall be grounds for refusal of employment or, if hired, dismissal from employment.Your name here will serve as your signature* First Last Date* MM DD YYYY
