Quality Dining, Inc. & Its Subsidiaries Application For Employment Page 2
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1
2List your last 3 employers, including any military service, starting with the present or most recent. If additional space is needed,
a separate sheet may be attached. Resumes, though welcome, should not be submitted in place of the information requested.
Company Name
)
Address
Phone No.
(Present or most recent employer
Position(s) Held
Job Duties
Dates of Employment
Rate of Pay
Average Hours Worked/Week
From__________
To__________
Starting _________ Ending __________
(month/year)
(month/year)
Supervisor's Name
May we contact?
Reason for Leaving
Company Name
Address
Phone No.
Position(s) Held
Job Duties
Dates of Employment
Rate of Pay
Average Hours Worked/Week
From__________
To__________
Starting _________ Ending __________
(month/year)
(month/year)
Supervisor's Name
May we contact?
Reason for Leaving
Company Name
Address
Phone No.
Position(s) Held
Job Duties
Dates of Employment
Rate of Pay
Average Hours Worked/Week
From__________
To__________
Starting _________ Ending __________
(month/year)
(month/year)
Supervisor's Name
May we contact?
Reason for Leaving
How many jobs have you held in the last 2 years? 0
1
2
3
4+
Have you ever been terminated from a job?
Yes No
If yes, how many jobs have you been terminated from:
1
2
3
4+
Please explain all periods of unemployment:
List professional references.
Name
Title
Company
Phone No.
Association with Applicant
Name
Title
Company
Phone No.
Association with Applicant
PLEASE READ THE FOLLOWING CAREFULLY AND SIGN BELOW.
I declare that I am qualified to perform all the duties of the position I am seeking. I also declare that the information provided in this application is correct
and that any false statements or omissions will justify my rejection for or dismissal from employment. I authorize the Company to conduct any necessary
investigation regarding my background (including inquiries of me, prior or current employers, schools and other persons, institutions, or businesses,
and checking motor vehicle records, court records and criminal records) as it relates to the position I am seeking and to the extent permitted by federal,
state and local law. I agree to complete the requisite authorization forms for the background investigation. I hereby release all parties from any liability in
connection with the provision and use of such information. Notwithstanding the foregoing, applicant does not waive liability for improper use of
information contained in the application or received while investigating the applicant's background. I will agree to a drug test, if permitted by law,
to be paid for by the Company. (The results of any drug test may, consistent with applicable law, be used to make employment decisions, including
decisions relating to hiring and continued employment.) I understand the Company cannot guarantee work hours and that as business dictates, I may be
required to work hours or perform job duties other than those for which I was originally employed.
I understand and agree that this application for employment does not create a contract for employment or a guarantee of employment. I understand
and agree that if I am hired, my employment is "AT-WILL" which means that my employment is for no definite period of time and either the Company or
I may terminate the employment relationship with or without cause at any time, with or without advance notice. I understand that only the President
or the Chief Executive Officer may change the AT-WILL status of any applicant or employee and may only do so in writing.
I understand that any policies or procedures implemented by the Company in the event of my employment do not alter my AT-WILL employment status.
I understand the Company, in its sole discretion, may at any time change its personnel policies and may also change my job description,
responsibilities, wages and benefits.
I HEREBY ACKNOWLEDGE AND UNDERSTAND THE NOTICE AS DESCRIBED ABOVE AND THAT IF I AM HIRED I WILL BE AN AT-WILL EMPLOYEE.
Signature of Applicant
Date
Your application will be considered active for 30 days. For consideration after that you must reapply.
EOE M/F D V
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