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Applicant Information

* Please include your FULL NAME as displayed on your government issued ID.

Name:*

Phone Number:*

Email:*

Address:*

City:*

Position Desired:*

State:*

When would you be able to begin work?

Are you legally eligible to be employed in the U.S?*

Are you over the age of 18 years?*

Have you ever worked for McDonald's before?*

If yes, where?

Availability

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Fri

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Sun

Previous Employment

If this is your first job put "first" for all previous employment questions

1. Company*

1. Location*

1. From*

1. To*

1. Phone*

1. Supervisor*

1. Reason for Leaving*

1. Pay Rate & Position*

May we contact your previous supervisor for a reference?

Notes

2. Company

2. Location

2. From

2. To

2. Phone

2. Supervisor

2. Reason for Leaving

2. Pay Rate & Position

May we contact your previous supervisor for a reference?

Education

Name and location of most recent school:*

Degree/diploma or highest level of education:*

Disclosure and Release

Answering yes will not necessarily bar you from employment. This information will only be used for job-related purposes consistent with applicable law and is only relevant in determining whether the conviction is related to the job for which you are applying. Factors such as age al the time of the offense(s), recentness of the offenses(s), seriousness of the offense(s), nature of the violation(s), its relation, if any, lo the job you are seeking, and rehabilitation will be taken into account. Failure to honestly answer these questions will result in discontinued consideration of your application or termination of employment. Do not report any conviction that has been sealed, expunged, statutorily eradicated, vacated, annulled, impounded, erased, nullified, dismissed, dismissed under a first offender's law, pardoned by the Governor, or which state allows you to lawfully deny. Do not report a record of any arrest, detention, process, diversion, supervision, adjudication or court disposition that was subject to the process and jurisdiction of a juvenile court. You also are not required to disclose violations, infractions or summary offenses.

Have you ever been convicted of, pled guilty to, or pled no contest to a crime excluding misdemeanors and traffic violations?*

If yes, please explain:

Are you or have you ever been a sex offender registered with any federal, state, or local government agency, including listing on a public website?*

I understand I am applying for employment with a McDonald's franchise, independent owner and operator. I certify that my answers are true and complete to the best of my knowledge, and I understand that any misrepresentation or omission of material fact will constitute grounds for immediate dismissal. I authorize companies, schools, and persons named above, and others, to furnish the above named employer with any information they may have regarding me. I agree that such companies, schools, persons, and others, shall not be liable in any respect if my employment is terminated because of misrepresentation or omission of material facts in this questionnaire. I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between the above named employer and me for either employment or for the providing of any benefit, and that my employers personnel policies and/or handbooks do not constitute an employment contract. I may be discharged at any time, with or without cause, and with or without notice, at any time, either at my option or at the option of my employer.

Signature:*

Date:*

Application for Employment

Lilly Enterprises Inc