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:
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
Sunday (Hours Available)
Monday (Hours Available)
Tuesday (Hours Available)
Wednesday (Hours Available)
Thursday (Hours Available)
Friday (Hours Available)
Saturday (Hours Available)
If Yes, please explain
Name of Emergency Contact
Relationship to you
Address
Phone
Place and Length of Employment
Employer’s Name/Address Name of Supervisor
Job Title/Duties
Salary
Reason for Leaving
Place and Length of Employment
Employer’s Name/Address Name of Supervisor
Job Title/Duties
Salary
Reason for Leaving
If no, indicate those you DO NOT want us to contact:
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)
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.
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