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APPLICANT INFORMATION

Full name:*

SSN:*

Date of Birth (DOB)*

Phone Number:*

Email:*

Address:*

City:*

Position Desired:*

State:*

Availability

Mon

Tue

Wed

Thu

Fri

Sat

Sun

When would you be able to begin work?*

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

Are you 16 years or older?*

Are you over the age of 18 years?*

Have you ever worked for McDonald's before? If so when and what location?*

Were you referred by anyone? If so who?*

PREVIOUS EMPLOYMENT

1. Company*

1. Location*

1. From

1. To*

1. Phone*

1. Supervisor*

1. Reason for Leaving*

1. Pay Rate & Position*

1. 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

2. 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

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 any 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.

Signatures*

Date*

Application for Employment

MTH Restaurants LLC