THANK YOU FOR APPLYING!
Thank you for your interest in working for Jucy’s Taco. Here at Jucy’s Taco, we want you to know that providing
quality service and products is the key to being successful. Our employees enjoy providing their customers with
the same kind of service they like to receive — friendly and fast. And they make certain our customers receive
quality food in a clean environment. They understand this is everyone’s responsibility, from the entry-level
employee to the owner of the company.
We believe our employees are our greatest asset. Because of this, we take the selection and hiring process very
seriously. We will call all of your previous employers and perform extensive reference checks. We do all of this
because, as your prospective employer, we are considering two very important questions:

Is this the right position for you?

Are you the best applicant for the position?
As your potential employer, we will consider you on the basis of your employment application, prior work
experience, pre-employment evaluations, and references. After reviewing your paperwork, we may contact you
to set up an interview.
Remember, we are trying to find a good match between the applicant and the position so that everybody benefits.
If the position is not right for you, do not be discouraged, but realize you are avoiding a negative work experience.
Again, thank you for applying with our organization. We wish you the best of luck in your job search.
Equal Opportunity Employer
M.A. Longview Management LLC; DBA: Jucy’s Taco
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Federal law prohibits discrimination on the basis of race, color, religion, disability, sex, or national origin, as well as discrimination on
the basis of age against persons over the age of 40. Some state and city legislation prohibits discrimination on the basis of age, marital
status, sexual preference, race, color, religion, sex, national origin, or any other basis prohibited by law. This employment application
is only active for 30 days. After this time period a separate employment application must be submitted in order to be considered for
employment.
PLEASE PRINT CLEARLY
Date________________________
PERSONAL
Name
First
Social Security Number
Middle
Last
Street
City
Address
State
Zip
List any other names you have worked under:
Phone Number with Area Code
(
)
Salary Expected
Are you at least 16 years old?
 Yes  No
List any friends or relatives employed by this company:
Are you legally eligible for employment in the U.S.?
 Yes  No
(Proof of U.S. citizenship or immigration status will be required if hired
for a position in the U.S.)
EMPLOYMENT DATA
Are you seeking:
 Temporary
How did you find out about this job?
Are you willing to work overtime?
 Full-time
 Part-time
What position(s) are you applying for?
 Newspaper
 Referral
 Other
 Yes  No
Weekends?
If hired, do you have a reliable means of transportation to get to work?
Are you currently employed?
 Yes  No
Are you on layoff and subject to recall?
 Yes  No
Where?
Holidays?
 Yes  No
 Yes  No
What is it?
If hired, when would you be able to start?
 Yes  No
If yes, explain:
Have you ever been discharged or asked to resign from any position?
 Yes  No
If yes, please described:
How many days have you missed or been late to school or work within the last 12 months for reasons other than personal
sickness? Days:
Explain:
Have you been convicted of a felony in the last seven years?  Yes  No On parole?  Yes  No
Awaiting trial?  Yes  No
Deferred Adjudication?  Yes  No If yes, state the nature of the offense and
disposition of the case. Include dates and places. Note: Felony convictions or the existence of a criminal record do not constitute an automatic bar to
employment.
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EDUCATION
(Please circle highest level attained)
Elementary
1 2
4
3
5
6
7
8
High School
9 10
11
12
G.E.D.
College
1 2 3
4
5
6
Name of School
Name of School
Name of School
Location of School
Location of School
Location of School
If currently in high school, are you enrolled in a recognized co-op program (such as
D.E., C.V.A.)?  Yes  No If yes, identify program and school:
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Degree and Major:
Date Graduated:
MILITARY SERVICE
Are you a veteran?
 Yes  No
Dates of service:
From:
To:
Special skills or training:
WORK HISTORY
Please list your last four employers. Begin with the most recent.
(If you have had more than four jobs in the last five years, attach another sheet.)
Company
Address
Phone
Job title
Specific reason for leaving
Supervisor’s name and title
Describe duties briefly
Starting salary
Ending salary
From
Mo. & Yr.
Company
Address
Phone
Job title
Specific reason for leaving
Supervisor’s name and title
Describe duties briefly
Starting salary
Ending salary
From
Mo. & Yr.
Company
Address
Phone
Job title
Specific reason for leaving
Supervisor’s name and title
Describe duties briefly
Starting salary
Ending salary
From
Mo. & Yr.
Company
Address
Phone
Job title
Specific reason for leaving
Supervisor’s name and title
Describe duties briefly
Starting salary
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From
Mo. & Yr.
Ending salary
To
Mo. & Yr.
To
Mo. & Yr.
To
Mo. & Yr.
To
Mo. & Yr.
May we contact all of these employers?
why.
 Yes  No
Have you ever worked for this organization before?
If not, tell us which one(s) you do not wish us to contact and
 Yes  No
If yes, list all locations to which you were assigned:
If yes, who was your last immediate supervisor when working here?
If hired, how long to you plan on working for this organization?
If hired, why would you quit your job with this organization?
PLEASE LIST THE NAMES AND TELEPHONE NUMBERS OF THREE PEOPLE, NOT RELATED TO YOU,
WHOM YOU HAVE KNOWN FOR AT LEAST ONE YEAR.
Name
Telephone Number
Name
Telephone Number
Name
Telephone Number
PLEASE READ THE FOLLOWING WAIVER CAREFULLY, INITIAL EACH STATEMENT, THEN SIGN AND
DATE THE APPLICATION.
I authorize this company to make an investigation of all information contained in this employment application and I
release from liability all companies and corporations that supply such information. I understand any false answers,
statements, or implications made by me on this application or other required documents shall be considered sufficient
cause for denial of employment or discharge.
I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any
other investigative report deemed necessary through various third party sources. Upon my formal written request,
within a reasonable period of time, I will be notified as to the nature and scope of such investigations.
I hereby agree to submit to any drug test required of me, whether prior to my employment or if employed by this
company at any time thereafter. If requested, I will take a physical examination, post-job offer, and employment will
be conditional upon passing such examination. During such employment, I understand and agree that, in the event I
receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric condition
that is job related, I hereby authorize the limited release and exchange of such medical information relating to my
condition between treatment provider and a company-designated physician.
The company reserves the right to submit all employment disputes to binding arbitration.
I have read and understand the above.
__________________________________________________________
Signature
__________________________________
Date
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