School most recently attended	Location	Phone

Graduated/Ged?   Yes   No   If no, Last grade completed:
Are you now enrolled?:  Yes   No

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Employment History

Company:	Position:
Address:	Phone:
Dates of Employment:-	Supervisor:
Description of duties:
Reason for leaving:

Company:	Position:
Address:	Phone:
Dates of Employment:-	Supervisor:
Description of duties:
Reason for leaving:

Company:	Position:
Address:	Phone:
Dates of Employment:-	Supervisor:
Description of duties:
Reason for leaving:

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 General Information

Have you ever worked at Burger King Restaurant? Yes No
If yes, what was your reason for leaving?:

Have you ever been discharged by a previous employer? Yes No
If yes, please explain:

HAVE YOU BEEN CONVICTED OF A FELONY OR MISDEMEANOR (OTHER THAT A TRAFFIC VIOLATION) WITHIN THE PREVIOUS SEVEN (7) YEARS (PREVIOUS (5) YEARS IF APPLICATION MADE IN NEW HAMPSHIRE)
Yes No

If yes, Please explain:
Note: A record of conviction does not disqualify you from employment consideration.

This Burger King Restaurant operates with multiple shifts, 7 days per week. Please indicate your preferred shifts in the chart below.
Total hours available per week:
Date available to start:
How were you referred to this independent franchisee?

	M	T	W	TH	F	SA	SU
FROM	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm
TO	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm	12am 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm

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Name:
Address:
Telephone:		Relationship:

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Independently Owned And Operated Franchised Burger King Restaurant

In completing this application, I understand that it is very important that I be completely truthful. I realize that the independent franchisee is relying on my truthfulness. I agree that if it should be discovered that the information I am providing is inaccurate, misleading, or incomplete in any respect, I will be disqualified from employment or, if I have already been hired, my employment will be terminated immediately.

I understand and agree that if I should become employed by the independent franchisee; I will have the right to terminate my employment at any time for any reason. I further agree that the independent franchisee shall have the same right to terminate my employment. My employment at-will status cannot be modified unless such modification is set forth in writing in an employment contracts and do not modify my status as an at-will employee.

I have read and understand the foregoing, I am seeking employment with the independent franchisee (not Burger King Corporation) under the terms set forth herein and that the independent franchisee is the sole employer of the employees at this restaurant. I certify and declare that all the information I have provided is true and correct.

If applicable to employment, I have read and understood the notice regarding polygraph tests and my right under Maryland law.

I authorize an investigation of all statements contained in this application. I authorize the references listed on this application to give you any and all information concerning my previous employment and release all parties from all liability for any damage that may result from furnishing such to you.

I certify that I have read and agree to the above