General Information
NAME *
First
First
Middle
Middle
Last
Last
ADDRESS *
Street Address
Street Address
City
City
State
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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 Armed Forces Americas Armed Forces Europe Armed Forces Pacific
Zip Code
Zip Code
CONTACT NUMBER * CONTACT NUMBER
ALTERNATE CONTACT NUMBERALTERNATE CONTACT NUMBER
EMAIL (OPTIONAL) * Email
DATE AVAILABLE FOR WORK (MM/DD/YYYY) * DATE AVAILABLE FOR WORK
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE UNITED STATES? *
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE UNITED STATES? Yes Yes No No
DO YOU NOW, OR WILL YOU IN THE FUTURE, REQUIRE IMMIGRATION SPONSORSHIP FOR WORK AUTHORIZATION (E.G., H-1B)?
DO YOU NOW, OR WILL YOU IN THE FUTURE, REQUIRE IMMIGRATION SPONSORSHIP FOR WORK AUTHORIZATION (E.G., H-1B)? Yes Yes No No
(If hired, verification will be required consistent with federal law.)
ARE YOU UNDER THE AGE OF 18?
ARE YOU UNDER THE AGE OF 18? Yes Yes No No
IF YOU ARE UNDER THE AGE OF 18, PLEASE STATE YOUR AGE.
IF YOU ARE UNDER THE AGE OF 18, PLEASE STATE YOUR AGE.
(The primary reason for this question is to address any child labor laws.)
HOW WERE YOU REFERRED TO SUB CRAZY?
HOW WERE YOU REFERRED TO SUB CRAZY?
Position Information
TYPE OF WORK DESIRED? *
TYPE OF WORK DESIRED? Busser Host/Takeout Server Bartender Dishwasher Food Prep Line Cook Pizza Maker General Manager
WAGE RANGE EXPECTED? *
WAGE RANGE EXPECTED?
APPLYING FOR: *
APPLYING FOR Full-Time Full-Time Part-Time Part-Time Seasonal Seasonal
Employment Record
List all employment experience for the past 7 years, starting with the most recent or present employer. Using a separate section for each position, describe in detail all work experience including periods of unemployment. You may include as part of your employment history any verified work performed on a volunteer basis. Resumés may not be substituted in lieu of completing the following employment information.
NOTE: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
PLEASE SELECT ONE OF THE FOLLOWING: *
PLEASE SELECT ONE OF THE FOLLOWING This is my first job (skip this section) This is my first job (skip this section) This is not my first job (continue filling out this section) This is not my first job (continue filling out this section)
Employer #1
EMPLOYER
EMPLOYER
City
City
State
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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 Armed Forces Americas Armed Forces Europe Armed Forces Pacific
PHONE
Phone
YOUR POSITION
YOUR POSITION
SUPERVISOR'S NAME / TITLE
SUPERVISORS NAME / TITLE
MAY WE CONTACT THEM?
MAY WE CONTACT THEM? Yes Yes No No
DATE STARTED
DATE STARTED
DATE ENDED
DATE ENDED
REASON FOR LEAVING
REASON FOR LEAVING
Employer #2
EMPLOYER
EMPLOYER
City
City
State
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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 Armed Forces Americas Armed Forces Europe Armed Forces Pacific
PHONE
Phone
YOUR POSITION
YOUR POSITION
SUPERVISOR'S NAME / TITLE
SUPERVISORS NAME / TITLE
MAY WE CONTACT THEM?
MAY WE CONTACT THEM? Yes Yes No No
DATE STARTED
DATE STARTED
DATE ENDED
DATE ENDED
REASON FOR LEAVING
REASON FOR LEAVING
Employer #3
EMPLOYER
EMPLOYER
City
City
State
State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia 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 Armed Forces Americas Armed Forces Europe Armed Forces Pacific
PHONE
Phone
YOUR POSITION
YOUR POSITION
SUPERVISOR'S NAME / TITLE
SUPERVISORS NAME / TITLE
MAY WE CONTACT THEM?
MAY WE CONTACT THEM? Yes Yes No No
DATE STARTED
DATE STARTED
DATE ENDED
DATE ENDED
REASON FOR LEAVING
REASON FOR LEAVING
Education
HIGH SCHOOL OR G.E.D. EQUIVALENT NAME AND LOCATION
HIGH SCHOOL OR G.E.D. EQUIVALENT NAME AND LOCATION
HIGHEST GRADE COMPLETED?
HIGHEST GRADE COMPLETED? 9 10 11 12 GED
COLLEGE OR UNIVERSITY NAME AND LOCATION
COLLEGE OR UNIVERSITY NAME AND LOCATION
DID YOU GRADUATE?
DID YOU GRADUATE? Yes Yes No No
Background Information
DURING THE PAST 7 YEARS, HAVE YOU EVER BEEN DISCHARGED, SUSPENDED OR ASKED TO RESIGN FROM ANY POSITION?
DURING THE PAST 7 YEARS, HAVE YOU EVER BEEN DISCHARGED, SUSPENDED OR ASKED TO RESIGN FROM ANY POSITION? Yes Yes No No
IF YES, PLEASE EXPLAIN.
comments
FOR THE PURPOSE OF VERIFYING INFORMATION ON THIS APPLICATION, HAVE YOU EVER WORKED OR ATTENDED SCHOOL UNDER A DIFFERENT NAME AT ANY OF THE ORGANIZATIONS YOU HAVE LISTED?
FOR THE PURPOSE OF VERIFYING INFORMATION ON THIS APPLICATION, HAVE YOU EVER WORKED OR ATTENDED SCHOOL UNDER A DIFFERENT NAME AT ANY OF THE ORGANIZATIONS YOU HAVE LISTED? Yes Yes No No
IF YES, PLEASE SPECIFY NAME IF YES, PLEASE SPECIFY NAME
Please note: A criminal background check may be required, if Sub Crazy later offers you employment. However, please also note that Sub Crazy does not have a policy that automatically disqualifies you from consideration from employment, if you have previously been convicted of a crime. Instead Sub Crazy will evaluate, on an individual basis, as to whether such a conviction should disqualify you from employment, reviewing a variety of factors, including the nature of the crime, the time elapsed, and the nature of the job.
Voluntary Self Identification Form
The Equal Opportunity Commission (EEOC) requires organizations with 100 or more employees to invite applicants to self-identify gender and race and complete an EEO-1 report each year. Completion of this data is voluntary and will not affect your opportunity for employment, or terms and conditions or employment. This form will be used for EEO-1 reporting purposes only and will be kept separate from all other personnel records only accessed by the Human Resources Department.
NAME
First
First
Last
Last
JOB TITLE
JOB TITLE
I AM
I AM Male Male Female Female
FOR THE PURPOSES OF THIS REPORT, I CONSIDER MYSELF
FOR THE PURPOSES OF THIS REPORT, I CONSIDER MYSELF Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race. Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race. White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa Black or African American (Not Hispanic or Latino): A person having origins in any of the black racial groups of Africa Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands Asian (Not Hispanic or Latino): A person having origins in any of the peoples of the Far East, Southeast Asia or the Indian Subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand ad Vietnam Asian (Not Hispanic or Latino): A person having origins in any of the peoples of the Far East, Southeast Asia or the Indian Subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand ad Vietnam American Indian or Alaskan Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. American Indian or Alaskan Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above races Two or more races (Not Hispanic or Latino): All persons who identify with more than one of the above races (Please only select one category)
IF YOU WISH TO NOT ANSWER, PLEASE CHECK THE BOX BELOW.
IF YOU WISH TO NOT ANSWER, PLEASE CHECK THE BOX BELOW. I do not wish to provide the information requested above I do not wish to provide the information requested above
DATE COMPLETED (MM/DD/YYYY)
Please Read Carefully and Initial Each Paragraph Before Submitting
I HEREBY CERTIFY THAT THE INFORMATION GIVEN BY ME IS TRUE IN ALL RESPECTS. I AUTHORIZE SUB CRAZY AND ITS REPRESENTATIVES TO CONTACT MY PRIOR EMPLOYERS AND ALL OTHERS FOR THE PURPOSE OF VERIFICATION OF THE INFORMATION I HAVE SUPPLIED AND RELEASE SAME FROM ANY LIABILITY RESULTING FROM THE INFORMATION RELEASED. I AUTHORIZE EMPLOYERS, SCHOOL SAND OTHER PERSONS NAMED ON THIS APPLICATION TO PROVIDE ANY INFORMATION OR TRANSCRIPTS REQUESTED. * I HEREBY CERTIFY THAT THE INFORMATION GIVEN BY ME IS TRUE IN ALL RESPECTS. I AUTHORIZE SUB CRAZY AND ITS REPRESENTATIVES TO CONTACT MY PRIOR EMPLOYERS AND ALL OTHERS FOR THE PURPOSE OF VERIFICATION OF THE INFORMATION I HAVE SUPPLIED AND RELEASE SAME FROM ANY LIABILITY RESULTING FROM THE INFORMATION RELEASED. I AUTHORIZE EMPLOYERS, SCHOOL SAND OTHER PERSONS NAMED ON THIS APPLICATION TO PROVIDE ANY INFORMATION OR TRANSCRIPTS REQUESTED.
I UNDERSTAND EMPLOYMENT WITH SUB CRAZY IS ALSO CONTINGENT ON MY PROVIDING SUFFICIENT DOCUMENTATION NECESSARY TO ESTABLISH MY IDENTITY AND ELIGIBILITY TO WORK IN THE UNITED STATES. *
I UNDERSTAND EMPLOYMENT WITH SUB CRAZY IS ALSO CONTINGENT ON MY PROVIDING SUFFICIENT DOCUMENTATION NECESSARY TO ESTABLISH MY IDENTITY AND ELIGIBILITY TO WORK IN THE UNITED STATES.
I UNDERSTAND I MAY BE SUBJECT TO A PRE-EMPLOYMENT DRUG TEST AFTER RECEIVING A CONDITIONAL OFFER OF EMPLOYMENT, AND MUST RECEIVE A NEGATIVE RESULT FOR ILLEGAL DRUGS BEFORE BEING PERMITTED TO COMMENCE WORK WITH SUB CRAZY. * I UNDERSTAND I MAY BE SUBJECT TO A PRE-EMPLOYMENT DRUG TEST AFTER RECEIVING A CONDITIONAL OFFER OF EMPLOYMENT, AND MUST RECEIVE A NEGATIVE RESULT FOR ILLEGAL DRUGS BEFORE BEING PERMITTED TO COMMENCE WORK WITH SUB CRAZY.
I EXPRESSLY UNDERSTAND AND AGREE THAT, IF EMPLOYED, MY EMPLOYMENT, HAVING NO SPECIFIC TERM, IS BASED UPON MUTUAL CONSENT AND MAY BE TERMINATED T WILL, WITH OR WITHOUT CAUSE, BY EITHER PARTY (SUB CRAZY OR ME) WITHOUT PRIOR WRITTEN NOTICE TO THE OTHER. * I EXPRESSLY UNDERSTAND AND AGREE THAT, IF EMPLOYED, MY EMPLOYMENT, HAVING NO SPECIFIC TERM, IS BASED UPON MUTUAL CONSENT AND MAY BE TERMINATED T WILL, WITH OR WITHOUT CAUSE, BY EITHER PARTY (SUB CRAZY OR ME) WITHOUT PRIOR WRITTEN NOTICE TO THE OTHER.
AS A CONDITION OF CONSIDERATION FOR EMPLOYMENT, I AGREE TO WAIVE MY RIGHT TO SUE, AND SUB CRAZY HEREBY WAIVES ITS RIGHT TO SUE ME, FOR ANY AND ALL CLAIMS OR CAUSES OF ACTION. IN LIEU OF SUING, ANY SUCH LEGAL DISPUTE MAY INSTEAD BE SUBMITTED BY ME AGAINST SUB CRAZY OR SUB CRAZY AGAINST MEMOIR A FINAL AND BINDING RESOLUTION BY A PRIVATE, IMPARTIAL ARBITRATOR. THE ARBITRATION SHALL BE GOVERNED BY THE EMPLOYMENT ARBITRATION RULES OF THE AMERICAN ARBITRATION ASSOCIATION THEN IN EFFECT. A COPY OF THESE RULES IS AVAILABLE BY ASKING SUB CRAZY'S HUMAN RESOURCES OR CAN BE FOUND AT WWW.ADR.ORG. THIS AGREEMENT DOES NOT APPLY TO OR COVER CLAIMS FOR WHICH ARBITRATION IS UNAVAILABLE, SUCH AS WORKERS' COMPENSATION, UNEMPLOYMENT COMPENSATION BENEFITS, OR CHARGES UNDER THE NATIONAL LABOR RELATIONS ACT. * AS A CONDITION OF CONSIDERATION FOR EMPLOYMENT, I AGREE TO WAIVE MY RIGHT TO SUE, AND SUB CRAZY HEREBY WAIVES ITS RIGHT TO SUE ME, FOR ANY AND ALL CLAIMS OR CAUSES OF ACTION. IN LIEU OF SUING, ANY SUCH LEGAL DISPUTE MAY INSTEAD BE SUBMITTED BY ME AGAINST SUB CRAZY OR SUB CRAZY AGAINST MEMOIR A FINAL AND BINDING RESOLUTION BY A PRIVATE, IMPARTIAL ARBITRATOR. THE ARBITRATION SHALL BE GOVERNED BY THE EMPLOYMENT ARBITRATION RULES OF THE AMERICAN ARBITRATION ASSOCIATION THEN IN EFFECT. A COPY OF THESE RULES IS AVAILABLE BY ASKING SUB CRAZYS HUMAN RESOURCES OR CAN BE FOUND AT WWW.ADR.ORG. THIS AGREEMENT DOES NOT APPLY TO OR COVER CLAIMS FOR WHICH ARBITRATION IS UNAVAILABLE, SUCH AS WORKERS COMPENSATION, UNEMPLOYMENT COMPENSATION BENEFITS, OR CHARGES UNDER THE NATIONAL LABOR RELATIONS ACT.
I CERTIFY, UNDER PENALTY OF PERJURY, THAT ALL OF THE ABOVE INFORMATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT ANY FALSIFICATION OR OMISSION OF INFORMATION MAY RESULT IN DENIAL OF EMPLOYMENT, IF HIRED, MAY RESULT IN TERMINATION REGARDLESS OF THE TIME LAPSE BEFORE DISCOVERY. *
I CERTIFY, UNDER PENALTY OF PERJURY, THAT ALL OF THE ABOVE INFORMATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT ANY FALSIFICATION OR OMISSION OF INFORMATION MAY RESULT IN DENIAL OF EMPLOYMENT, IF HIRED, MAY RESULT IN TERMINATION REGARDLESS OF THE TIME LAPSE BEFORE DISCOVERY.
Note: An offer of employment is conditioned upon complying with Sub Crazy's requirements including, but not limited to signing a consent to conduct a background investigation and signing the Company's standard proprietary information agreement and arbitration agreement.
TYPING MY NAME REPRESENTS MY SIGNATURE AND IS EVIDENCE THAT I HAVE READ AND AGREE WITH ALL OF THE ABOVE STATEMENTS. * TYPING MY NAME REPRESENTS MY SIGNATURE AND IS EVIDENCE THAT I HAVE READ AND AGREE WITH ALL OF THE ABOVE STATEMENTS.
DATE (MM/DD/YYYY)
DATE