Please Print |
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THIS SIDE TO BE COMPLETED BY APPLICANT |
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An Equal Opportunity Employer |
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PERSONAL INFORMATION |
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Last Name |
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First Name |
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MI |
Do you have any relatives working for this Jimmy John’s store? ❑ Yes |
❑ No |
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If “Yes”, give name, relationship, department/location. |
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Street Address |
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Box/Apt. |
Home Phone |
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Cell Phone |
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Referred By: ❑ Newspaper/Advertisement ❑ Individual |
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❑ Gov’t Agency ❑ Employment Agency ❑ College ❑ Other |
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City |
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State |
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Zip Code |
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Have you ever been employed by this or any |
If “Yes”, please complete this line: |
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Name of Supervisor |
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Location |
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other Jimmy John’s store? ❑ Yes |
❑ No |
Date of Employment |
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From: |
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To: |
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Position Desired |
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Employment Desired |
Hours Available |
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Have you ever been convicted of a felony? ❑ Yes |
❑ No |
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If “Yes”, explain: |
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❑ Full Time |
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From |
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❑ Part Time |
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Criminal convictions must be disclosed on this application and will |
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be considered prior to an offer of employment only as applicable to |
Are you under 18 years of |
If “Yes” please provide birth date. |
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the position applied for and the date and nature of the crime. Jimmy |
age? |
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To |
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John’s does not take into consideration for the basis of employment |
❑ Yes |
❑ No |
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the fact of an arrest or criminal history record information ordered |
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expunged, sealed or impounded. |
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EDUCATION (Name and address of school) |
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Major |
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Number of Years |
Diploma/Degree |
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Signature |
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College |
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I understand that this application was made |
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available on line in an effort to assist me in applying |
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for a position with an independently owned Jimmy |
High School |
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John’s Gourmet Sub Shop. I acknowledge that this |
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application will be made in association with the |
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owner of the Jimmy John’s Sub Shop I am applying |
Other |
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to work for and that is the entity referred to as |
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“Employer” on the application. I agree that I shall not |
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file a claim, lawsuit, charge or cause of action of any |
EMPLOYMENT (List most recent job first) |
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kind arising out of my employment with Employer |
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Company |
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Address |
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Name of Supervisor |
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or the termination of my employment any later than |
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the 180th day after my termination and |
that my |
Job Title/Duties Performed |
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Phone # (Area Code) |
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From |
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To |
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agreement to shorten |
any applicable |
statue of |
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limitations under any state or federal law is without |
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( |
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Mo. |
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Mo. |
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Yr. |
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prejudice to my rights to bring any such claim should |
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Reason for Leaving |
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Starting Pay |
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Ending Pay |
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I so choose. Upon hire, I agree that this application |
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forms a binding contract of the terms above between |
Company |
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Address |
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Name of Supervisor |
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myself and my employer. I certify that the information |
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contained in this application is correct to the best |
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of my knowledge and understand that falsification |
Job Title/Duties Performed |
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Phone # (Area Code) |
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From |
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To |
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of this information may be grounds for dismissal in |
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( |
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Mo. |
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Mo. |
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Yr. |
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accordance with the Employers policy. I authorize |
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Reason for Leaving |
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Starting Pay |
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Ending Pay |
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the references and supervisors listed above to give |
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you any and all information concerning my pervious |
Company |
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Address |
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Name of Supervisor |
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employment and any |
pertinent information |
they |
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may have personal or otherwise and release all |
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parties from all liability for any damage that may |
Job Title/Duties Performed |
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Phone # (Area Code) |
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From |
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To |
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result from furnishing same to you. In consideration |
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( |
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Mo. |
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Mo. |
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Yr. |
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of my employment, I agree to conform to the |
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Reason for Leaving |
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Starting Pay |
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Ending Pay |
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rules and regulations of Employer and that my |
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employment and compensation can be terminated at |
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any time with or without cause, at the option of either |
MAY WE CONTACT YOUR PRESENT EMPLOYER? |
❑ Yes |
❑ No |
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the company or myself. |
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PERSONAL REFERENCES (Not former employers or relatives) |
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Signature |
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Date |
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