1General Information2Employment Information3Education Information4 Desired Location* Emerald Isle Wilmington 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* Month Day Year Have you ever been convicted of a crime/felony?* Yes No If yes, please explain.Was the offense drug or alcohol related? Yes No If 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.?* Yes No We do not permit smoking while on duty. Are you willing to comply?* Yes No RuckerJohns does not tolerate drug use by employees before or during work, or on RuckerJohns premises. Are you willing to comply?* Yes No Position applying for* Server Host/Hostess Kitchen Salary desired Date available to start work* Month Day Year 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)?* Yes No Up to 50 lbs. of lifting several times a day is an essential function of kitchen positions. Are you willing and able to comply?* Yes No Being on your feet 6-9 hours at a time is a requirement in dining room positions. Are you willing and able to comply?* Yes No Third Choice RuckerJohns may train/have meetings on days you have other obligations. Are you willing to reschedule your plans to come to training/meetings?* Yes No If 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?* Yes No Are you presently employed?* Yes No Place of current employment May we contact your present employer? Yes No List your previous employers (start with most recent)Company Immediate Supervisor PhonePosition held Date started Date left Reason for leaving Company Immediate Supervisor PhonePosition held Date started Date left Reason for leaving Company Immediate Supervisor PhonePosition held Date started Date left Reason for leaving Any other related experience? High School* Starting date Ending Date Graduated?* Yes No College or University Starting date Ending Date Graduated? Yes No Area of Study Affirmation 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* Month Day Year
