Application Date
North Little Rock Online Employment Application


First Name
Last Name
Middle Name

Street Address
Apt Number

City
State
Zip

Home Phone
Cell Phone
Email

Position Applying For Salary Desired
Available Start Date

Hours Available Monday
Hours Available Tuesday

Hours Available Wednesday
Hours Available Thursday

Hours Available Friday
Hours Available Saturday

Hours Available Sunday

Are you able to perform the responsibilities of the position with reasonable accommodations?
Yes No
Do you have reliable transportation?
Yes No
Do you use any tobacco products?
Yes No
Would you commit to working hard and being a team player?
Yes No
Can you provide proof of eligibility to work in the United States?
Yes No
*Have you been convicted of or pleaded no contest to a felony within the last 5 years?
Yes No
*Answering yes will not necessarily bar you from employment. Applicants are not required to disclose sealed or expunged conviction records or the existence of such records.

May we contact your current or last employer?
Yes No
1.Employer Name
Address

Phone Number
Job Title

Dates Worked: From
To
Primary Responsibilities

Reason For Leaving


2.Employer Name
Address

Phone Number
Job Title

Dates Worked: From
To
Primary Responsibilities

Reason For Leaving


3.Employer Name
Address

Phone Number
Job Title

Dates Worked: From
To
Primary Responsibilities

Reason For Leaving


High School Name and Location

High School Major/Subject or Study

High School Graduation Date

College or University Name and Location

College or University Major/Subject or Study

College or University Graduation Date

Specialized Training Name and Location

Specialized Major/Subject or Study

Specialized Training Graduation Date

Other Education Name and Location

Other Education Major/Subject or Study

Other Education Graduation Date


1. I certify that I have read this application and the information on it is complete and correct. I understand that any omissions or misrepresentation of information is grounds for dismissal.
2. David’s Burgers is an Equal Opportunity Employer. Various federal, state, and local laws prohibit discrimination on account of race, color, religion, sex, age and national origin, disability, sexual orientation, veteran status or other protected categories. It is David’s Burgers policy to comply fully with these laws, as applicable, and information requested on this application will not be used for any purpose prohibited by law.

There were errors on the form, please correct the fields in red and submit again.