Form Fa 0509 - Employment Application (Page 2 of 2) in pdf

Form Fa 0509 - Employment Application Page 2

EMPLOYMENT HISTORY

List employment starting with your most recent position. You may include a description of verified work performed on a volunteer basis.

Is any additional information relative to a different name necessary to check your work record?

If yes, explain.

Yes

DATES

NAME AND ADDRESS

POSITION HELD

LIST MAJOR

SALARY OR

REASON

OF EMPLOYER

AND SUPERVISOR

DUTIES

WAGES

FOR LEAVING

From:

Name

Your Job Title

Starting

mo.

yr.

Address

Supervisor

Final

To:

City & State

Phone

mo.

yr.

(

)

Your Job Title

Starting

Name

From:

mo.

yr.

Address

Supervisor

Final

To:

City & State

Phone

mo.

yr.

(

)

Name

From:

Your Job Title

Starting

mo.

yr.

Address

Supervisor

Final

To:

City & State

Phone

mo.

yr.

(

)

From:

Name

Your Job Title

Starting

mo.

yr.

Address

Supervisor

Final

To:

City & State

Phone

mo.

yr.

(

)

Have you previously worked for Dunkin’ Donuts or any of its subsidiaries or Franchisees?

Yes

Location

Name

City & State

Position Held

Supervisor

Dates Employed From:

To:

Reason for Leaving

REFERENCES

Business references: (do not list relatives)

Name

Address

Work Phone No.

Title

Years Known

PLEASE READ CAREFULLY

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I

understand, also, that I am required to abide by all rules and regulations of the Franchisee of Dunkin’ Donuts.

I understand and agree that if employed, employment will be “AT WILL.” That is, either I or the employer may end the employment relationship at any time, for

any reason, or for no reason. I understand that receipt of this application does not imply employment and that this application and/or any other documents are not

contracts of employment.

I understand that I am applying for work with (one or more) Dunkin’ Donuts Franchisees, and not Dunkin’ Brands, Inc. or any of its affiliates. If hired the Franchisee

will be my only employer. Franchisees are independent business people who set their own wage and benefit programs that can vary among Franchisees.

APPLICANT’S SIGNATURE

DATE SIGNED

FA 0509