Page 1 of 9Personal InformationDate*NameFirstLastAddress*City, State, Zip*Cellular Phone*Email address*May We Contact You at Work?*YesNoNextAvailabilityPosition Applying For:Crew MemberShift LeaderManagerDate Available to Start*Are You Interested In (check all that apply):*Full-timePart-timeTemporarySummerWhat Shifts Are You Available? (Check all the apply. Shifts start as early as 5am)*I have open availability and can work any shiftsMonday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMSunday AMSunday PMAre You Willing to Relocate?*YesNoAre You 18 Years or Older? (no one under age 16 may be hired)*YesNoHow Were You Referred to Us?BackNextEducationName of High School (or equivalent)AddressCity, State, ZipDegree/Area of StudyNumber of Years AttendedGraduated (Check one)YesNo Name of CollegeAddressCity, State, ZipDegree/Area of StudyNumber of Years AttendedGraduated (Check one)YesNo OtherAddressCity, State, ZipDegree/Area of StudyNumber of Years AttendedGraduated (Check one)YesNoBackNextU.S. Military Service (leave blank if not applicable)Branch of ServiceTechnical SpecializationRank AttainedBackNextLegalAre you legally authorized to work in the United States?*YesNo(Identity and employment eligibility of all new hires will be verified as required by the Immigration Reform and Control Acts of 1986.)Were you ever discharged by any company?*YesNoIf yes, please give name of company(ies).Reason for discharge:Federal, State, and local laws prohibit discrimination based on race, color, sex, religion, affectional or sexual orientation, national origin, ancestry, age, physical or mental disability that does not affect ability to perform essential job function(s) with or without reasonable accommodation, or any other protected status not listed in this statement. Your application will be considered in full accord with applicable Federal, State, and local requirements.BackNextEmployment History Is any additional information relative to a different name necessary to check your work record?*YesNoIf yes, explain.List employment starting with your most recent position. You may include a description of verified work performed on a volunteer basis.Start DateEnd DateName of EmployerAddress of EmployerCity, State, ZipYour Job TitleSupervisorList Major DutiesReason For Leaving Start DateEnd DateName of EmployerAddress of EmployerCity, State, ZipYour Job TitleSupervisorList Major DutiesReason For Leaving Start DateEnd DateName of EmployerAddress of EmployerCity, State, ZipYour Job TitleSupervisorList Major DutiesReason For Leaving Start DateEnd DateName of EmployerAddress of EmployerCity, State, ZipYour Job TitleSupervisorList Major DutiesReason For Leaving Have you previously worked for Dunkin' or any of its subsidiaries or Franchisees?*YesNoStart DateEnd DateName of EmployerAddressCity, State, ZipYour Job TitleSupervisorList Major DutiesReason For LeavingBackNextReferences Business References (do not list relatives): Name*Title*Work Phone Number*Years Known*Address*City, State, Zip* NameTitleWork Phone NumberYears KnownAddressCity, State, Zip NameTitleWork Phone NumberYears KnownAddressCity, State, Zip BackNextResumeUpload Your Resume Here (not required to apply) Additional NotesPlease include any additional information you feel would be relevant for the hiring manager in the box above.BackNextPlease Read CarefullyIn the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of the Franchisee of Dunkin' Donuts. I understand and agree that if employed, employment will be "AT WILL." That is, either I or the employer may end the employment relationship at any time, for any reason, or for no reason. I understand that receipt of this application does not imply employment and that this application and/or any other documents are not contracts of employment. I understand that I am applying for work with (one or more) Dunkin' Donuts Franchisess, and not Dunkin' Brands, Inc. or any of its affiliates. If hired the Franchisee will be my only employer. Franchisees are independent business people who set their own wage and benefit programs that can vary among Franchisees.I have thoroughly read the above statements. Applicant's Signature*I acknowledge that my typed name above serves as my electronic signature.Date Signed*BackSendThis field should be left blank
