Popeyes Application Form Page 2
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1
2EMPLOYMENT HISTORY
(Please list your last three employers. Begin with the most recent employer.)
1.
Company ____________________________________________
Phone Number
_______________________
Address __________________________________City/State/Zip _________________________________________
Dates of Employment:
______________
_______________
Salary:
_____________
_____________
From
To
Beginning
Ending
Job Title ____________________________________ Supervisor’s Name & Title ____________________________________
Type of Job:
Full-time
Part-time Job Description and Responsibilities: ________________________________________
Were you fired:
Yes
No Give specific reason for leaving ___________________________________________________
If we contacted this employer, would you expect them to say they would rehire you for the position you last held there?
Yes
No
Explain ______________________________________________________________________________________________
2.
Company ____________________________________________
Phone Number
_______________________
Address __________________________________City/State/Zip _________________________________________
Dates of Employment:
______________
_______________
Salary:
_____________
_____________
From
To
Beginning
Ending
Job Title ____________________________________ Supervisor’s Name & Title ____________________________________
Type of Job:
Full-time
Part-time Job Description and Responsibilities: ________________________________________
Were you fired:
Yes
No Give specific reason for leaving ___________________________________________________
If we contacted this employer, would you expect them to say they would rehire you for the position you last held there?
Yes
No
Explain ______________________________________________________________________________________________
3.
Company ____________________________________________
Phone Number
_______________________
Address __________________________________City/State/Zip _________________________________________
Dates of Employment:
______________
_______________
Salary:
_____________
_____________
From
To
Beginning
Ending
Job Title ____________________________________ Supervisor’s Name & Title ____________________________________
Type of Job:
Full-time
Part-time Job Description and Responsibilities: ________________________________________
Were you fired:
Yes
No Give specific reason for leaving ___________________________________________________
If we contacted this employer, would you expect them to say they would rehire you for the position you last held there?
Yes
No
Explain ______________________________________________________________________________________________
How many jobs have you had in the last five years that are not listed above?
_________________________________________________________________
LEGAL
If yes, date of conviction__________
Have you ever been convicted of a crime other than a routine traffic violation?
YES
NO
_______________________________________________________________________________________
Please explain
__________________________________________________________________________________________________
SIGNATURE
By signing this application for employment, I certify that I have read and understand all parts of it and certify that I have truthfully and completely answered all
questions. I understand that falsification of any of the information given herein or on any other employment form is grounds for immediate termination, regardless of
when such falsification may be discovered.
I authorize Popeyes and its representatives to investigate my education, employment experience, criminal conviction records, and all other aspects of my background
relevant to my proposed employment, including all statements made by me in my application for employment. I understand Popeyes may contact the appropriate credit
bureau to obtain an investigative consumer report providing information about my character; I understand I may request (in writing from the Personnel Department) a
complete and accurate disclosure of information concerning the nature and scope of this report. I also release Popeyes and its representatives, as well as any person to
whom such inquiry is directed, from any liability arising directly or indirectly from such investigations.
Further, I understand my employment may be terminated at any time, with or without cause, at the option of either Popeyes or myself. I understand that no
employee or representative of Popeyes has any authority to make any agreement, which is contrary to the foregoing. If accepted for employment, I agree to comply
with all company policies and procedures and with all rules and regulations made known at the time of employment or any other time thereafter, and to perform all
duties assigned to me to the best of my ability.
Signature _________________________________________________________________ Date _________________
Popeyes is an equal opportunity employer. All applications for employment will be considered without regard to race, color, religion, sex, national origin, disability, or
age (over the age of 40). This application will remain active for 45 days. After that time, it must be renewed by the applicant if he/she wishes to be reconsidered for
employment.
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