Employment Application

Personal Information

First Name*:		Middle Name:
Last Name*:		Current Street Address:
City:		State:
Zip Code:		Email Address*:
Daytime Phone*:		Evening Phone:

Referred By:
Are you less than 18 years of age?*:	yes no
Are you legally eligible for employment in the U.S.?	yes no
Have you been convicted of a felony in the last seven (7) years?	yes no
If yes, list convictions that are a matter of public record (arrests are not convictions). A conviction will not necessarily disqualify you for employment.

Employment Desired

Position:		Location*:
Salary Desired*:		Date you can start:

Kinder's general operating hours are Monday thru Sunday, 8:00 A.M.- 8:00 P.M.
Specify hours available for each day of the week*

Have you ever worked for Kinder’s?	yes no
If Yes, When?
Which Location?	= '';
Are you able to work overtime?	yes no

Education

	Name and Address of School	Years Completed	Did You Graduate?	Subjects Studied / Degree Received
High School
College
Post College
Trade School

After employment, can you furnish documentation proving the legal right to remain and work in the United States.

yes no

Name any friends or individuals you know who are presently employed by Kinder’s:

What method of transportation will you use?

How many days have you been absent in the past 12 months for any reason? (Please explain)

Former Employers

List below current and last three employers, starting with most recent one first.
Please include any non-paid/volunteer experience which is related to the job for which you are applying.
Please complete even if you attach a resume.

Employer 1

Employer Name and Address of Employer-Type of Business:		Duties Performed:
Start Date:		End Date:
Starting Salary / Hourly Rate:		Ending Salary / Hourly Rate:
Position:		Average # of hours per week:
Supervisor's Name:		Phone Number:
Reason For Leaving:		May We Contact?	yes no

Employer 2

Employer Name and Address of Employer-Type of Business:		Duties Performed:
Start Date:		End Date:
Starting Salary / Hourly Rate:		Ending Salary / Hourly Rate:
Position:		Average # of hours per week:
Supervisor's Name:		Phone Number:
Reason For Leaving:		May We Contact?	yes no

Employer 3

Employer Name and Address of Employer-Type of Business:		Duties Performed:
Start Date:		End Date:
Starting Salary / Hourly Rate:		Ending Salary / Hourly Rate:
Position:		Average # of hours per week:
Supervisor's Name:		Phone Number:
Reason For Leaving:		May We Contact?	yes no

Employer 4

Employer Name and Address of Employer-Type of Business:		Duties Performed:
Start Date:		End Date:
Starting Salary / Hourly Rate:		Ending Salary / Hourly Rate:
Position:		Average # of hours per week:
Supervisor's Name:		Phone Number:
Reason For Leaving:		May We Contact?	yes no

References

Give below the names of three professional references, whom you have known at least one year.

	Name	Address and Phone Number	Business	Years Acquainted	How Do You Know This Person?
Reference: 1
Reference: 2
Reference: 3
Reference: 4

Terms

I hereby authorize Kinder’s to thoroughly investigate my background, references, employment record and other matters related to my suitability for employment. I authorize persons, schools, my current employer (if applicable), and previous employers and organizations contacted by Kinder’s to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in rejection of this application, or if hired, discipline up to and including dismissal. I understand that I may be required to sign a confidentiality and/or non-compete agreement, should I become an employee of JR Kinder’s, Inc.. I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate Kinder’s to hire me. I understand and agree that my employment is at will, which means that it is for no specified period and may be terminated by me or Kinder’s at any time without prior notice for any reason.

Date:
Signature*:	( First and Last Name )

WE ARE AN EQUAL OPPORTUNITY EMPLOYER COMMITTED TO HIRING A DIVERSE WORKPLACE. COURTESY * SPEED * ACCURACY