DOUGHBY’S
36 WEST HIGH STREET
Oxford Ohio 45056
Employment Application
APPLICANT INFORMATION
Last Name
First
M.I.
Street Address
Apartment/Unit #
City
Phone
State
(
Date of birth
)
ZIP
Social Security #
Date Available
Are you under the age of 18?
YES
NO
If yes, pleases state age?
Are you a citizen of the United States?
YES
NO
If no, are you authorized to work in the U.S.?
Have you ever been convicted of a felony?
YES
NO
If yes, explain?
Name
In case of emergency please notify
Phone #
YES
NO
Relationship
AVAILABILITY
Position you are applying for?
Kitchen
Driver
Both
How many hours per week are you available?
Are you able to work late nights and
weekends?
YES
NO
Are you able to work holidays?
YES
NO
Do you have transportation to make it
in for scheduled shifts
YES
NO
Posted hours are:
Mon-Wed 11 am - 3 am
If no, explain?
If no, explain?
Thur-Sat 11 am – 4 am
Sun 11 am – 2 am
Availability
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
EDUCATION
High School
From
To
Did you graduate?
YES
NO
To
Did you graduate?
YES
NO
College
From
Degree
SATURDAY
SUNDAY
Other
From
To
Did you graduate?
YES
NO
Degree
REFERENCES
Please list three professional references.
Full Name
Relationship
Company
Phone
(
)
(
)
(
)
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
PREVIOUS EMPLOYMENT
Company
Phone
Address
Supervisor
Job Title
Starting Salary
(
)
$
Ending Salary
$
Ending Salary
$
Ending Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
(
)
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
$
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?
YES
NO
(
)
MILITARY SERVICE
Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable, explain
DRIVER POSITION ONLY
Delivery vehicle
Make
Year
Doughby’s Breakfast
Doughby’s has recently began serving breakfast on Saturday and Sunday mornings from 8 am to 2 pm and is looking to fill these positions
as well. Please check yes or no if you are available for these shifts.
YES
NO
Doughby’s Catering
Doughby’s has recently began event catering for special occasions and is looking to fill these positions as well. Please check yes or no if
you are interested in catering opportunities.
YES
NO
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.
I understand that my employment is for no definite period and that I may be terminated at any time without prior notice.
I understand that if I am employed as a delivery driver that I will be responsible for the operation and maintenance of my car. I will keep a
valid driver’s license and my car will be insured and registered as required by law. I am responsible for any accidents or tickets which may
occur and I will not hold Doughby’s or any of its affiliates accountable for the following: Damages, accidents, preventative maintenance
(wear and tear), or traffic violations.
I agree that as a driver or kitchen employee I will work at least one shift on Green Beer Day. There will be no exceptions!
Signature
Date
FOR OFFICE USE ONLY
Scheduled interview
Designated start date
Supervisor
Trained under
Has the employee been informed of and filled out
all the necessary paperwork?
Employee’s release
Date and time
Supervisor
Date and time
YES
NO
Supervisor
Reason
Date and time