PLEASE READ THIS FORM VERY CAREFULLY BEFORE FILLING IN YOUR ANSWERS.

Full Name (REQUIRED)

Email (REQUIRED)

Phone Number (REQUIRED)

Present Address (REQUIRED)

Previous Address (REQUIRED)

Position Desired (REQUIRED)
ServerBartenderBusserHostManagerCookDishwasher/Prep

Start Date (REQUIRED)

Salary Desired (REQUIRED)

Which times can you work? (REQUIRED)
MorningsAfternoonsEveningsWeekends

Full TimePart Time

Approximate number of hours desired (REQUIRED)

Comments on work schedule:

Please fill out the schedule you desire (PLEASE NOTE: If you are filling this out on a mobile device, you may have to turn it to the horizontal view to gain access to the entire chart):

Do you have reliable transportation, including public transportation, to get to work? Yes

Are You a U.S. Citizen? (REQUIRED) YesNo
If not a U.S. Citizen, will you, before employment, submit verification of your legal right to work in the U.S.? Yes

Are you of legal age (18) to serve alcoholic beverages? Yes

If you are under 21 years of age, please state your age (If so, proof of legal age is required prior to employment.):

Schools Attended:

Other

Current or most recent employer

Do you have any obligations, such as school or another job, that will influence your work schedule? If yes, please explain.

Can you perform the necessary functions to carry out the job that you are applying for?Yes

Can we get in touch with you by telephone daily if necessary? Yes

Do you have any physical or mental limitations that might limit you job duties? (REQUIRED) NoYes
If you answered "Yes" please explain. (THIS FIELD IS REQUIRED IF YOU ANSWERED "YES")

Can you respect the rights of others, conduct yourself professionally, and comply with the rules and regulations of this establishment? Yes

Do you consent to a Drug Test if the owner or manager requests one? (REQUIRED) Yes

ALL APPLICANTS MUST READ CAREFULLY AND SIGN BELOW:

I have carefully read and understand this application for employment at the Juicy Lucy's Burger Bar and Grill. I understand that any false or incomplete information
in an application for employment is a serious matter and is grounds for dismissal and forfeiture of related benefits. I also understand that my employment is
“at will” and I can be terminated without cause and without prior notice. I hereby give permission to this establishment to investigate my previous
employment, educational background, information regarding my character, and general reputation. I agree not to discuss my rate of pay, or the rate of pay
of others, with other Juicy Lucy's Burger Bar and Grill employees. I agree to conform to the rules and regulations of the company. I also agree to full release of liability to
Juicy Lucy's Burger Bar and Grill for providing reference to all potential employers in the event of my termination. I release all persons who furnish such
information to Juicy Lucy's Burger Bar and Grill from all liability and damages. I request employment with the understanding that I will not give any information to
any person, corporation, or firm, pertaining to the Juicy Lucy's Burger Bar and Grill's business, including recipes, properties, trade secrets, product information,
account information, business processes, records, statistics, pricing practices, ordering information, trade names, trademarks, customer information, etc. I
understand that the penalty for employee theft or sabotage will be termination and prosecution. I agree to return all property of the restaurant upon
termination or resignation. By signing below I acknowledge I understand this application and agree to follow the rules and regulations set forth by this
establishment.

Applicant's Signature (REQUIRED)
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