Home  »  Jobs at Tri-Arc  »  Application Form	Saturday, July 05, 2008

Personal Information First Name: Middle Name: Last Name: Address: City: State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code: Phone #1:   include area code Phone #2:   include area code E-Mail Address: Have you been previously employed at any Bojangles? Yes     No If yes, please complete the following Dates of Employment: Location: Reason for Leaving: Do you have friends or relatives currently employed at Bojangles? Yes     No If yes, Name: Location: Have you ever applied for a managemnent position with us before? Yes     No If yes, When: Do you have reliable transportation? Yes     No Do you have a valid Driver's License? Yes     No Are you authorized to work in the United States? Yes     No Are there any times of the day or days of the week that you are unavailable to work? Yes     No If yes, please explain: Are you able to perform the essential functions of the position without accomodations? Yes     No If you do require accomodations, please detail these accomodations: Are you over the age of 18? Yes     No Have you ever been convicted of, pled no contest to, or are now subject to a charge of any felony, or a misdemeanor involving violence, sexual assault, fraud or embezzlement? (A charge or conviction won't necessarily disqualify you from employment) Yes      No If yes, please explain: Salary Requirements:   Education       High School Name: City: Last Grade Completed: 1       2       3       4 Graduate? Yes        No       College Name: City: Last Grade Completed: 1       2       3       4 Dates: Graduate? Yes        No       Other Name: City: Last Grade Completed: 1       2       3       4 Dates: Graduate? Yes        No   Employment Experience Employer #1: Location: Phone:    include area code Job Title: Your Supervisor: Date Worked From: Date Worked To: Reason for Leaving: May we use this employer as a reference? Yes     No Employer #2: Location: Phone:    include area code Job Title: Your Supervisor: Date Worked From: Date Worked To: Reason for Leaving: May we use this employer as a reference? Yes     No Employer #3: Location: Phone:    include area code Job Title: Your Supervisor: Date Worked From: Date Worked To: Reason for Leaving: May we use this employer as a reference? Yes     No   Questionnaire Are you able to stand/walk for periods of 2-5 hours without a rest / break, and can you perform repetitive tasks that include frequent bending, lifting in excess of 25 lbs., reaching overhead, and walking on slippery surfaces? Yes     No Are you able to work a 50 hour, 5 day work week, including most weekends? Yes     No Do you have at least 2 years restaurant experience in a management, supervisory, crew leader, team leader or crew trainer position? Yes     No Do you have at least 3 years high volume restaurant management experience? Yes     No Do you have at least 3 years restaurant management in a high volume casual dining setting? Yes     No Will you consent to a background check (criminal, credit, DMV)? Please note that an imperfect record will not automatically disqualify an applicant from being hired, but failure to disclose all information on the application will. Yes     No

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