Fillable Printable Long John Silver's Application Form
Fillable Printable Long John Silver's Application Form
Long John Silver's Application Form
PLEASE TELL US ABOUT YOURSELF.
Last Name First Name
MI
Preferred Name
Current Address
City State Zip Code Years There
Most Recent Previous Address
City State Zip Code Years There
Social Security Number Are you 16 or older?
Yes No
Home Telephone ( ) Cell Phone or Pager ( )
WHAT WOULD YOU LIKE TO DO AT THIS FRANCHISE STORE?
Team Member
Team Leader
Assistant Manager
Restaurant General Manager
Other
Full Time
Part Time
Desired Salary/Wage
$
Per Hour
Annually
How did you find out about A&W/Long John Silver’s?
Availability*
From:
To:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
WHAT SCHOOLS HAVE YOU ATTENDED?
High School:
College:
Other:
Name, City, State
Dates
Diploma or Degree Received
From To
Do not answer Do not answer
TWO MOST RECENT JOBS
Company and Address. If currently employed, may we contact? Yes No Telephone Supervisor Name
Dates Worked What did you do? Last Salary/Wage
$
Per Hour
Annually
Why did you leave?
Company and Address. If currently employed, may we contact? Yes No Telephone Supervisor Name
Dates Worked What did you do? Last Salary/Wage
$
Per Hour
Annually
Why did you leave?
*If your religious beliefs or practices prohibit you from working on a particular day or at a particular time, The Franchisee will make reasonable efforts to accommodate those beliefs or practices in accordance with applicable law.
This A&W/Long John Silver’s operator (“The Franchisee”) is an Equal Opportunity Employer. Applications for all job openings are welcome and will be considered without regard to race, gender, age, national origin, color, religion, disability,
sexual orientation, marital status, veteran status, or any other basis protected by applicable federal, state, or local law.
Throughout this application, “The Franchisee” refers to the independent A&W/Long John Silver’s Franchisee which operates this restaurant. A&W/Long John Silver’s, the Franchisor, is not your employer and does not own or operate this restaurant.
MISCELLANEOUS INFORMATION
Do you have reliable transportation to get to work?
Yes No
If hired, when could you begin work? If hired, can you show proof of your legal right to work in the United States?
Yes No
If you have worked for or have applied for employment with any of the
Company Stores, Franchisees, or Licensees listed below, please check the
appropriate boxes and then provide the information requested to the right.
A&W Pizza Hut
Long John Silver’s Yum! Brands
Taco Bell Franchisee/Licensee
KFC Company
Company Name and Address
Telephone Dates Worked
Supervisor’s Name Last Salary/Wage
$
Per Hour
Annually
What did you do? Why did you leave?
REFERENCES (PLEASE DO NOT INCLUDE FAMILY MEMBERS AS REFERENCES.)
Name Relationship to You How long have you known
this person?
Type of Reference
(School, Work, or Personal)
Telephone
OTHER INFORMATION ABOUT YOURSELF
1. Have you ever been convicted of, or pled guilty, no contest or
nolo contendere
to a crime involving, in any way, violence, sex, indecency, stalking, minors, theft, property damage, weapons,
dishonesty, fraud, robbery, burglary, or drugs?* Yes No If you answered yes, please answer the following:
* Crimes include felonies and misdemeanors only, not infractions or summary offenses. You should not respond “Yes” as a result of any conviction that has been judicially sealed, annulled, expunged, erased, statutorily eradicated, dismissed by a First
Offender’s statute, or pardoned by the Governor. Conviction of a crime will not necessarily disqualify you from consideration for employment and will be considered only as it relates to the job in question. CALIFORNIA residents do not respond “Yes” for
(i) misdemeanor convictions for which you have successfully completed or otherwise discharged probation; (ii) misdemeanor marijuana convictions if the conviction occurred more than two years ago; (iii) any past arrest or detention not resulting in a
conviction; or (iv) any referral to or participation in a pretrial or post trial diversion program. HAWAII residents, you are not required to answer this question (although you will be required to answer it as to convictions within the past ten years if you receive
an offer). KENTUCKY residents, do not respond “Yes” as a result of any misdemeanor conviction where the date of conviction was more than five years ago. MASSACHUSETTS residents, do not respond “Yes” as a result of any misdemeanor conviction where
the date of the conviction or the completion of incarceration, whichever date is later, occurred more than five years ago. WASHINGTON residents, do not respond “Yes” if your conviction and your release from any time spent in incarceration each occurred
more than ten years ago.
2. Are you currently charged with a crime involving, in any way, violence, sex, indecency, stalking, minors, theft, property damage, weapons, dishonesty, fraud, robbery, burglary, or drugs for which
you have not been convicted or that has not been dismissed or otherwise resolved?** Yes No
** Residents of ALASKA, CALIFORNIA, HAWAII, ILLINOIS, and RHODE ISLAND, do not answer this question. Residents of OREGON, VIRGINIA, and WASHINGTON, do not answer “Yes” for charges pending longer than one year. Residents of MICHIGAN, do not
answer “Yes” as a result of pending misdemeanor charges.
AGREEMENT (PLEASE READ, SIGN, AND DATE BELOW.)
Nature of my Employment. If I am hired by The Franchisee, I agree that I will be an at-will employee, which means that either I or The Franchisee may end my employment at any time, with
or without cause or notice. I agree that no written materials or verbal statements by The Franchisee will constitute an express or implied contract of continued employment and that this
at-will relationship can only be modified in writing by The Franchisee’s head of Human Resources. I agree that, if hired, I will obey The Franchisee’s rules, including treating confidentially any
information I learn during my employment.
My Participation in The Franchisee’s Drug Free Environment. I am not a current user of illegal drugs, and I agree I will never work under the influence of drugs or alcohol.
My Records and References. There is nothing in my background that would cause a risk to The Franchisee’s customers, employees, or property. I authorize The Franchisee to conduct
reference checks, criminal and driving records checks, and other consumer report investigations. I release all parties from any liability for providing such information to The Franchisee. In this
regard, I understand that conviction of a crime will not necessarily disqualify me from consideration for employment. I understand that the nature and date of the offense and the relevance of
the offense to the position(s) applied for will determine my eligibility for employment.
Information Certification. I certify that the information I have provided to The Franchisee is true and complete. I agree to notify The Franchisee immediately if I am later charged with any of
the crimes listed above. I agree that any false information or omission allows The Franchisee to refuse to hire me, or to terminate my employment at any time.
The Dispute Resolution Program. If The Franchisee has a Dispute Resolution Program, this application requires you to arbitrate any legal dispute related to your application for employment with
The Franchisee under said Program, which may require mandatory and binding arbitration under the American Arbitration Association “National Rules for the Resolution of Employment Disputes.”
Applicant’s Signature Date
INFORMATION FOR MARYLAND AND MASSACHUSETTS RESIDENTS
UNDER MARYLAND AND MASSACHUSETTS LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED
EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS SUBJECT TO PENALTY.
INFORMATION FOR CONNECTICUT RESIDENTS
You are not required to disclose the existence of any arrest, criminal charge, or conviction, the records of which have been erased pursuant to section 46b-146, 54-76o, or 54-142. If your only
criminal record consists of items that have been erased under the statutes listed above, then you may state on this form that you have not been arrested.
Date of Conviction (or plea of guilty, no contest, or
nolo contendere):
Date sentence or parole completed:
