Apply to Our Springfield, Ohio Location Please complete the form below and our hiring manager will be in touch with you shortly First Name Last Name SSN Email Home Phone Mobile Address City Zip Code Birthday Have you been previously employed by Rudy’s Smoke House, or RJM Smoke House LLC? If yes, list dates of employment, location, position held, and supervisor’s name: Are you a U.S. Citizen? Yes No If no, do you possess an alien registration card? Yes No What are you interests, hobbies, extra-curricular activities (exclude those religious or ethnic in nature) Position applying for FT or PT hours per week Date Available Wage Desired Please indicate below the days and hours you are available to work: Sunday (Hours Available) Monday (Hours Available) Tuesday (Hours Available) Wednesday (Hours Available) Thursday (Hours Available) Friday (Hours Available) Saturday (Hours Available) Have you ever been convicted of a felony? Yes No If Yes, please explain Name of Emergency Contact Relationship to you Address Phone JOB HISTORY (1) Place and Length of Employment Employer’s Name/Address Name of Supervisor Job Title/Duties Salary Reason for Leaving JOB HISTORY (2) Place and Length of Employment Employer’s Name/Address Name of Supervisor Job Title/Duties Salary Reason for Leaving May we contact the past and/or present employers listed above? Yes No If no, indicate those you DO NOT want us to contact: EDUCATION HISTORY High School (Name) High School (Graduated) High School (Major/Minor) College (Name) College (Graduated) College (Major/Minor) Trade/Bus Sch. (Name) Trade/Bus Sch. (Graduated) Trade/Bus Sch. (Major/Minor) REFERENCES (List three people you have known, at least one year, exluding relatives) Are you known to schools/references by another name? Yes, No If yes, please indicate the name used: Do you authorize investigation of all statements contained in the application, except where I have requested on this form that no investigation be made. I hereby certify that the facts set forth in this application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal. I also understand RJM Smoke House, LLC, is a Drug Free Workplace Establishment, which subjects all employees to Post Incident and Random Drug Testing. It is further understood my employment is for an indefinite period of time; that regardless of how long I work for RJM Smoke House, LLC I may be disciplined, laid-off, and/or discharged at any time without cause and without prior notice, and that I, at all times during my employment server merely at the will and option of my employer notwithstanding any other expressed or implied, written or verbal, statements by any other individual, which may be made to the contrary. Send
