First Name: Middle Name:
    Last Name: Birthdate:
    Current Address: City:
    State: Zip:
    Permanent Address: City:
    State: Zip:
    Current Phone Number: Permanent Phone Number:
    Cell Phone Number: Email Address:
    Have you ever been employed by Smokin' Jack's in the past?
    If so, dates of employment: Reason for leaving:
    Do you know a current or past employee of Smokin' Jack's?
    If yes, who?
    Are you legally eligible for work in the United States?
    (if hired, verification is required by law)
    Have you been convicted of a crime in the last 7 years?
    If yes, please list convictions that are a matter of public record (an arrest is not a conviction). A conviction will not necessarily disqualify you from employment.
    Are you of legal age to serve alcohol?
    Do you have reliable means of transportation to work?
    What position(s) are you applying for?
    If applying for Delivery Driver, have you been involved in a moving vehicle violation in the last 7 years?
    (Smokin' Jack's will check the motor vehicle records of any job applicant, in every State of previous employment, when driving is an essential job function)
    If yes, please list:
    What skills do you have that are applicable to position(s) applied for?
    Date available for employment:
    If hired, how long do you plan to be employed by Smokin' Jack's?
    How many hours are you able to work per week?
    (Smokin' Jack's is open for business 6 days a week)
    Do you have any regularly scheduled or intermittent obligations that may affect your availability to work?
    If yes, please list:
    Specify hours available each day of the week:

    Education
    High school
    Name and Address of School:
    Last year completed: Did you Graduate?
    Subjects studied, Degrees received:
     
    College
    Name and Address of School:
    Last year completed: Did you Graduate?
    Subjects studied, Degrees received:
     
    Post College
    Name and Address of School:
    Last year completed: Did you Graduate?
    Subjects studied, Degrees received:
     
    Trade, business or correspondence school
    Name and Address of School:
    Last year completed: Did you Graduate?
    Subjects studied, Degrees received:

    Employment History

    Provide information for your last 3 employers starting with the most recent. If never employed, list any volunteer activities
    Employer 1: Supervisor:
    Position held: Dates (From: to)
    Location: Phone Number:
    Last rate of pay: Reason for leaving:
    Are you eligible for rehire?
     
    Employer 2: Supervisor:
    Position held: Dates (From: to)
    Location: Phone Number:
    Last rate of pay: Reason for leaving:
    Are you eligible for rehire?
     
    Employer 3: Supervisor:
    Position held: Dates (From: to)
    Location: Phone Number:
    Last rate of pay: Reason for leaving:
    Are you eligible for rehire?

    Personal References
    Name: Phone Number:
    Occupation: Relationship:
    Years acquainted:
     
    Name: Phone Number:
    Occupation: Relationship:
    Years acquainted:
     
    Name: Phone Number:
    Occupation: Relationship:
    Years acquainted: