Rapid Roberts

Rapid Robert's Employment Application

Personal Information

*Full name
*Street address
*City
*State
*Zip
*Telephone number ex(999)999-9999
Email
Have you ever worked at Rapid Robert's before?	Yes No
If so, when? ex (01/01/00)	to
Position
Division
Have you ever applied at Rapid Robert's before?	Yes No
If so, when? (ex 01/01/00)
Can present employer be contacted?	Yes No
Do you have reliable transportation?	Yes No
Were you referred by a Rapid Robert's employee?	Yes No
If so, whom?
Desired location
*Desired starting pay ($)	Per hour Per week
*How many hours per week do you want to work?
During what times are you available to work?
*Are you willing to work: (Check all that apply.)	Nights Overtime Weekends Holidays
*When could you begin work? (ex 01/01/00)
Are you at least 18 years old?	Yes No
Have you ever been convicted of a felony?	Yes No

Skills and Experience

Please list any special qualifications, training, education, skills, or experience that you feel warrant consideration by the company.

Please list any business equipment operating abilities you have which might be useful on the job for which you are applying.

Education

Did you graduate from high school or earn a GED?	Yes No
Name and location of college, university, business or trade school
Full-time or part-time	Full-time Part-time
Major field of study
Degree conferred
Hours credit

Work Experience

May we contact your present employer?	Yes No
Name of present or last employer
Type of business
Street Address
City
State
Dates of employment	to
Starting salary
Leaving salary
Job title
Name of supervisor
Type of job
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain
Employer's phone number ex (999)999-9999

Name of employer prior to job above
Type of business
Street Address
City
State
Dates of employment ex.(01/01/00)	to
Starting salary
Leaving salary
Job title
Name of supervisor
Type of job
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain
Employer's phone number ex (999) 999-9999

Name of employer prior to job above
Type of business
Street Address
City
State
Dates of employment ex (01/01/00)	to
Starting salary
Leaving salary
Job title
Name of supervisor
Type of job
Explain reasons/circumstances for changing or wanting to change jobs
If we contact this employer, would you expect them to say they would rehire you for a position you last held there?	Yes No
If no, please explain
Employer's phone number ex(999) 999-9999

Comments

If you have anything else you would like to add please type it in the box below.

*Certification And Agreement

I certify that the facts set forth in this Application For Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application could lead to disciplinary action including dismissal. I understand that the Company will run a credit check on me. The Company is hereby authorized to investigate any of the facts set forth in this application.

I understand that employment at this Company is "at will," which means that either I or the Company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager or executive of the Company, other than the President, has any authority to alter the foregoing.

Yes
No

* Required