Home  »  Jobs at Tri-Arc  »  Information Form	Thursday, February 23, 2012

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: Position Applying For: Crew     Management Location, if Crew: Have you been previously employed at any Bojangles? Yes     No If yes, please complete the following Dates of Employment: Reason for Leaving: 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 over the age of 18? Yes     No Have you ever been convicted for any violation of the law other than minor traffic violations? (A conviction will not necessarily disqualify you for the job. Each situation will be considered on a case by case basis.) 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 Graduate? Yes        No       Other Name: City: Last Grade Completed: 1       2       3       4 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 Employer #4: 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 #5: 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

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