MJG Corporation Application for Employment

Federal and State Law prohibit discrimination in employment because of race, color, sex, religion, age, national origin, physical or mental handicap. 

On-line or mail-in Application

Name (First, Middle, Last)

Street Address, Apt/Suite, City, State, ZIP Code

How long have you lived at this address?

Previous Street Address, Apt/Suite, City, State, ZIP Code

How long have you lived at this address?

Social Security Number

Today’s Date

Date of Birth(if under age 18)

Date available to begin work

Position applying for

Crew Member: No experience required

Shift Manager: Food service or retail experience required

Asst Mgr or Unit Mgr: Management experience required

Salary Requirement

Do you have transportation to work?

Are you authorized to work in the United States?

Do you have a valid driver’s license?

Yes

 

No

 

Yes

 

Yes

 

No

 

No

 

Do you have a relative employed at MJG Corporation

Yes

 

No

 

If yes, who?

Education

High School

College

Graduate School

Trade or Other

School Name and Location

Did you Graduate

Yes

 

Yes

 

Yes

 

Yes

 

No

 

No

 

No

 

No

 

GPA

Degree / Courses

Military Service

Branch of Service

Date Entered

Discharge Date

Rank

Availability

Days and Hours available.

From

To

Day

Mon

Tues

Wed

Sat

Sun

Have you ever been employed at MJG Corporation

Yes

 

No

 

If yes, when and where?

During the past 7 years, have you ever been convicted of a crime, excluding misdemeanors and traffic violations

Yes

 

No

 

If yes, describe in full

The Secretary of Health and Human Services has determined that certain diseases, including hepatitis A, salmonella, staphylococcus, giardia, and campylobacter may prevent you from serving food or handling  food in a sanitary or healthy fashion.  An essential function of this job involves handling and serving food, food service equipment and utensils in a sanitary and healthy fashion.  Is there any reason why you cannot perform the essential functions of this job?

Yes

 

No

 

If yes, explain:

Past Employment

Company

Date Started

Date Left

City and State

Ending base salary or hourly wage

Job Title

Supervisor

Phone

Eligible for Re-Hire?

Resigned with Notice

 

No

 

Reason for Leaving

Resigned without Notice

 

Terminated

 

Past Employment

Company

Date Started

Date Left

City and State

Ending base salary or hourly wage

Job Title

Supervisor

Phone

Eligible for Re-Hire?

Resigned with Notice

 

No

 

Reason for Leaving

Resigned without Notice

 

Terminated

 

Past Employment

Company

Date Started

Date Left

City and State

Ending base salary or hourly wage

Job Title

Supervisor

Phone

Eligible for Re-Hire?

Resigned with Notice

 

No

 

Reason for Leaving

Resigned without Notice

 

Terminated

 

What additional relevant experience or training have you had other than your work experience, military service and education?

General

Activities—civic, athletic, fraternal, etc.

Comments:

Benefits

Health Insurance

Dental Insurance

Life Insurance

Vacation Plan

Bonus Incentive

Meal Discounts

MJG Corporation offers these benefits to those who qualify:

PLEASE READ CAREFULLY THE SECTION BELOW BEFORE SIGNING.

1. I certify that the information contained in this application is correct to the best of my knowledge and understand that any omission or erroneous information is grounds for dismissal in accordance with MJG Corporation’s policy.

2. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

3. I understand that as a part of the processing procedure for my employment application an investigative report may be made concerning my character, general reputation, personal characteristics, and mode of living.  Upon written request, additional disclosure concerning the complete nature and scope of the investigation will be provided.

4. If I am denied a job based either wholly or in part because of information contained in a consumer report, I will(upon written request) will be provided the name and address of the reporting agency that supplied the information.

Applicant Signature

Date

MJG Corporation

Yes

 

Yes

 

Yes