APPLY FOR A JOB WITH J. R. Crickets®
PERSONAL INFORMATION - (R) indicates required field
Name:   (R)
 Street:   (R)
City/State/Zip:   (R) 
Date of Birth:
  (R)   Social Security Number:   (R)  
Telephone:

  (R)

  E-Mail: . (R)
Emergency Contact:  Name: (R) Telephone                              (R)
What is your Citizenship?:
  (R)   Are you authorized to work in the US?:   (R)
Criminal Record:
Have you ever plead "guilty" or "no contest" to or have been convicted of a crime?
  (R)  If yes, please give details.
Have you ever worked for J. R. Crickets®?   (R)
How were you referred to J. R. Crickets®?:   (R)
List any past or present employees that you know:
 

 

  
EDUCATION INFORMATION
High School Name:  
City/State:  
Years Attended:
    Graduation Date:
University/College Name:  
City/State:  
Years Attended:
    Graduation Date:
Other Education:
1.
2.
3.
Special Skills & Qualifications:  
   
REFERENCES
Reference #1:
Name:
Street:
City/State:  
Telephone:
Years Known:   Relationship to You:
Reference #2:
Name:
Street:
City/State:
Telephone:
Years Known:   Relationship to You:
   
PREVIOUS EMPLOYMENT
Employer #1:
Company Name:
Street:
City/State:  
Employment Dates:: Start Date: End Date:
Still Employed There?:    May we contact this employer?:
Supervisor Name:
Telephone:
Reason for Leaving:
Pay Rate: Starting Rate:   Ending Rate:
Job Responsibilities:
Employer #2:
Company Name:
Street:
City/State:
Employment Dates:: Start Date: End Date:
Still Employed There?:    May we contact this employer?:
Supervisor Name:
Telephone:
Reason for Leaving:
Pay Rate: Starting Rate:   Ending Rate:
Job Responsibilities:
Employer #3:
Company Name:
Street:
City/State:  
Employment Dates:: Start Date: End Date:
Still Employed There?:    May we contact this employer?:
Supervisor Name:
Telephone:
Reason for Leaving:
Pay Rate: Starting Rate:   Ending Rate:
Job Responsibilities:
   
EMPLOYMENT DESIRED
Date you can begin work:
  (R)   Salary Desired:   (R)
How can you be of service to J. R. Crickets®?:  
Employment position(s) desired
(check all that apply):
Cook   Wait Staff   Counter/Bar    
Other:  
Hours desired
(check all that apply):
Full Time   Part Time   Days   Nights
List any time you cannot work or have regularly scheduled commitments:
 
GEORGIA LOCATIONS:
Select maximum three different locations to send your application:
Location GEORGIA Choice #1:     (R)
Location GEORGIA Choice #2:    
Location GEORGIA Choice #3:    
MISSOURI LOCATIONS:
Select maximum three different locations to send your application:
Location MISSOURI Choice #1:     (R)
Location MISSOURI Choice #2:    
   
   
RELEASE

IMPORTANT: I hereby release employers, schools, or persons from all liability in responding to inquiries in connection with my application.

By submitting this application, I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial or medical history and other related matters as may be necessary for an employment decision.

IMPORTANT: Print this page before clicking Submit below. You must bring the printed, signed and dated copy with you to your interview.

Signature:_______________________________ Date:____________
 

Page Updated 04/27/2013

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