Applicant Information: Name:   City: Address:   State: Phone:   Zip:

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Please Answer the Following Questions: Are you age 18 or older? Yes No Are you legally able to be employed in the U.S.? Yes No Have you ever worked for us before? Yes No If yes, date of employment: Availability: Full-Time Part-Time Applying for: Hourly Management Expected wage or salary: Which restaurant are you applying for? Denny's Grandy's Papa John's JoJo's Long John Silver's Rally's Wendy's Which State are you applying to work in ? Indiana Kentucky Illinois Michigan     Are you re-locatable? Yes No

Times You Can Work:   Mon Tue Wed Thu Fri Sat Sun From: To: