Round Rock Donuts
106 W. Liberty
Round Rock, TX 78664
Application for Employment
(512) 255-3629
APPLICANT INFORMATION
Last Name
First
M.I.
Street Address
Apartment/Unit #
City
Zip
Code
State
Phone
E-mail Address
Date Available To Start
Position
Applied for:
_____ /_____ /_____
____________________
Social
Security No.
_____- _____- ______
Available to Work:
Are you authorized to work in the United
States?
YES
NO
Have you ever been convicted of a felony?
YES
NO
Desired Wage
High
School
Please Circle All Days Available to Work:
Full Time
Mon
Did you graduate?
College
From
NO
Degree
NO
Degree
NO
Degree
Address
To
Did you graduate?
Other
From
YES
YES
Address
To
Did you graduate?
YES
REFERENCES
Please list three references, not related to you, whom you have known at least one year.
Full Name
Relationship
Years
Known
Phone
(
)
Address
Full Name
Relationship
Years
Known
Phone
(
)
Address
Full Name
Relationship
Years
Known
Phone
Address
(
Tues
Wed
Thurs
Fri
Sat
Sun
_____________________________________
_____________________________________
_____________________________________
If yes, please explain
Address
To
$___________
Part Time
EDUCATION
From
Date
)
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
Training and Skills
Do you have experience working in the food service industry?
YES
NO
Do you have prior customer service experience?
YES
NO
Have you ever been involved in a work situation where a
customer was unhappy or unsatisfied with the services
provided?
YES
NO
If yes, please
explain:____________________________________
___________________________________________
___________________________________________
___________________________________________
If yes, please
explain:____________________________________
___________________________________________
___________________________________________
___________________________________________
If yes, please explain how you helped to resolve the
situation:___________________________________
___________________________________________
___________________________________________
___________________________________________
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 authorize investigation of all statements contained herein and the references and employers listed above to give you any and all
information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the
company from all liability for any damage that may result from utilization of such information.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with
Disabilities Act (ADA) and other relevant federal and state laws.
Signature
Date