304 S. Ashley St, Ann Arbor, MI 48104 tel.734.663.
4590
[email protected]
Thanks for your interest in working at Krazy Jims Blimpyburger! A lot of teamwork goes
into making this place run smoothly while providing a great dining experience to our
customers. In this small business, every employee learns and masters many skills- from
dishwashing to grilling, you must want to do it all! We are looking for outgoing, energetic
employees who are able to juggle multiple tasks well, all while having fun with co-workers
as well as the customers.
If this type of fast paced work environment excites you, hurry up and fill this out so we
can start grillin with you.
The Basics (please print legibly)
Name
Date
Address
Name
City
Phone
State
Zip
Email
Other Important Stuff
Are you legally eligible for employment in the United States?
Yes
No
Are you at least 18 years of age?
(If not, no worries, you just need a work permit)
Yes
No
Have you ever been convicted of a criminal offense?
Yes
No
If yes, please explain (use additional sheet of paper if necessary):
Date:
Place:
Nature:
An affirmative answer will not automatically disqualify you from being considered
Fdsafdsadafd
What Type of Job Are You Looking For?
Part Time Full Time Temporary
Until when? ___/___/___
Desired Wage?
Start Date?
_____
Please fill in your availability:
M
Notes:
Th
Su
AM
PM
Do you have commitments to another employer that might affect employment with us?
Do you have reliable transportation/can you use the bus? ______________________
(Employees are eligible for a free unlimited bus pass)
How did you hear about this job?
______________________________________
If you are a student, will you be in town over the break?
Yes
No
N/A
Tell Us About Your Work History
Please List present or recent employers first. Please fill out even if you are submitting a resume.
Employer:
Address:
Email:
Telephone: (
Duties:
Employed from:
Supervisor:
Your Job Title:
Salary Start:
Employer:
Address:
Email:
Telephone: (
Employed from:
Supervisor:
Your Job Title:
Salary Start:
May we contact?
Reason for
leaving:
to:
End:
Duties:
May we contact?
Reason for
leaving:
to:
End:
Employer:
Address:
Email:
Telephone: (
Duties:
Employed from:
Supervisor:
Your Job Title:
Salary Start:
Employer:
Address:
Email:
Telephone: (
Employed from:
Supervisor:
Your Job Title:
Salary Start:
May we contact?
Reason for
leaving:
to:
End:
Duties:
May we contact?
Reason for
leaving:
to:
End:
Please list any other certifications, qualifications, military service or volunteer service:
Education
School
High
School
College
Other
Name and Location
# of Yrs
Attended
Did You
Graduate?
Degree/ Area of Study
Please answer the following questions
Blimpys experiences periods of high volume business. What makes you believe you can perform
well under these fast paced, stress filled working conditions?
In your last job, what did you do during your down time?
Describe an incident where you experienced poor customer service. How would you have handled it
differently had you been in the other persons shoes?
What do you expect to gain from working at Blimpys?
When we check with your references, what do you think they will name as your:
Strengths?
Weaknesses?
Anything else you want to share with us?
The Agreement (please sign)
I hereby affirm that the information provided on this application is true to the best of my knowledge. I also agree that
falsifying information or significant omissions may disqualify me from further consideration for employment and may be
considered justification for dismissal if discovered at a later date. I understand that employment can be terminated, with
or without cause, at any time at the discretion of the company and myself. I authorize persons, schools, my current
employer and previous employers and organizations named in this application to provide any relevant information that
may be required to arrive at an employment decision.
Signature: _______________________________________ Date: _____________________________
