Application Page

Application for Employment

Please double check your information. If you need assistance in completing this application, then please let us know so we can discuss a reasonable accommodation.

Date of Application:

What type of position are you interested in?

Which store locations are you applying for a position?

Personal Information

First Name: Middle Name: Last Name:


Street Address:
Town/City:
State: Zip-code:


Day Phone Number:
Evening Phone Number:


How did you learn about Benny's?

Have you applied here previous?
yesno
If yes, please give dates:

Are you under 18 years old?
yesno
If yes, please give DOB:

If hired and under 18, can you furnish a work permit?
yesno

If applicable, what is your military status?
activeinactive Branch:

Are you legally authorized to work in the United States?
yesno
(If hired, you will be required to submit proof of your identity and legal work authorization as a condition of employment.)

Do you have any relatives employed by Benny's?
yesno
If yes, please give any name(s) of employee(s); store location; and duration of employment:

Have you ever been employed by Benny's?
yesno
If yes, please give dates of employment:
-

Do you have any specific salary requirements?
yesno
If yes, please indicate:

Employment Information

Date available to start work, if hired:

Total hours available per week: hours

Type of hours desired:
Full-Time:Part-Time:

Monday: to
Tuesday: to
Wednesday: to
Thursday: to
Friday: to
Saturday: to
Sunday: to

Do you have transportation to/from work?
yesno

Will you travel, if the job requires it?
yesno
If yes, please indicate:
minutes

Do you have a valid driver's license?
yesno

Can you perform the functions of the job for which you applied with or without a reasonable accommodation?
yesno

Can you meet the attendance requirements of this job?
yesno

Education

High school name:
Town/City: State:

Highest grade of education completed:
High School: College:

Diploma or GED received?
yesno

College (List all whether or not degree was received. Please include address, majors, minors, degrees received and highest grade level achieved there):

Academic honors, awards, or special recognition:

Extra curricular activities:

Other night school, correspondence, home study or courses not listed above:

Do you have any objection to our contacting the school you previously attended?
yesno
If yes, please explain:

Working Skills

If applicable, please check all of your current skills:
CashierSalesCustomer ServiceClerical/OfficeTruck DriverBike AssemblyTire InstallationWarehouse Stock

Computer Programs Used:

Other Skills you have that will allow you to perform job for which you applied:

Employment Record Information

Please identify all of your employment relationships for the past ten (10) years, starting with your most recent position. You may include military service and any verifiable work performed on a voluntary basis. All information requested must be provided and complete. While you may attach your resume, it cannot be submitted in lieu of completing this Application. Benny’s reserves its right to refuse to consider any incomplete Employment Application.

1. Current/Last Employer

Type of Business:
Address:
Phone Number:
Employment Dates: to
Job Title:
Salary: per | Bonuses/Incentives:
Duties/Responsibilities:
Supervisor's Name:
Reason(s) for leaving:
May we contact them? yesno

2. Previous Employer

Type of Business:
Address:
Phone Number:
Employment Dates: to
Job Title:
Salary: per | Bonuses/Incentives:
Duties/Responsibilities:
Supervisor's Name:
Reason(s) for leaving:
May we contact them? yesno

3. Previous Employer

Type of Business:
Address:
Phone Number:
Employment Dates: to
Job Title:
Salary: per | Bonuses/Incentives:
Duties/Responsibilities:
Supervisor's Name:
Reason(s) for leaving:
May we contact them? yesno

Required Notice

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. Massachusetts law also prohibits employers from inquiring about a job applicant's criminal history on its Job Application. However, certain limited criminal history information can be the subject of inquiry at a job interview.

Signature

Read carefully before sending

1. I understand that my receipt of this Application does not imply that I will be employed by Benny’s.

2. The statements and information provided by me in this Application are true and complete. I understand and acknowledge that I will be subject to immediate dismissal (if hired), or Benny’s can refuse to hire me if, at any time, Benny’s discovers that I provided any material falsification, omission, or misrepresentation of fact in this Application.

3. I authorize Benny’s to conduct a background inquiry to verify the statements and information provided by me in this Application, or other documentation that I provided to Benny’s in connection with this Application, and other areas that may include prior employment, consumer credit, motor vehicle history, and other reports, as authorized by law. I authorize all previous employers or other persons who have knowledge of me, or my records, to release such information to Benny’s. I hereby release any individual, business entity, agency, Benny’s, and Benny’s officers, employees and representatives from all claims or liabilities of any kind and nature that may arise from the request to disclose, and disclosure of such information.

4. I understand and acknowledge that if I am hired by Benny’s, I may be required, depending upon my position with Benny’s, to sign a non-compete, confidentiality, non-solicitation, and/or other employment agreements, as a condition of my at-will employment.

5. I understand and acknowledge that all employees of Benny’s are employees at will. If I am hired, I will be free to resign at any time. Likewise, Benny’s will have the right to terminate my employment at any time, with or without any reason or notice, regardless of the date of payment of my salary or wages. I understand and acknowledge that neither the completion by me of this Application, nor any other documents and/or communications provided by Benny’s to its job applicants and/or employees is intended to create, nor should such documents be construed as creating, an express or implied contract of employment under any circumstances.

My Submitted Application Certifies That I Have Read, Understand And Agree With The Above Statements.
 

(If application is printed please sign and date the application with the lines below)

Signature: _____________________________________________
 
Date: _______________________________________________
 

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