PERSONAL INFORMATION
First Name:		Initial:		Last Name:
Street Address:   City:
State:    Zip Code:    Work Phone:
Home Phone:    E-Mail:
Social Security Number:			May we contact you at work? Yes No
What position are you applying for?
Date Available to Start: (mm/dd/yy)   Are you willing to relocate? Yes No
Are you interested in (check all that apply): Full-time Part-time Temp Summer
If under 18, enter your date of birth (no one under 16 may be hired):  (mm/dd/yy)
Please write in the days of the week and times you are available to work. Example: "Mondays from 4:00 PM to 10:00 PM. Saturdays at any time."
Willing to travel? Yes No			Referred to Wendy's By:    Advertising Friend Relative Job Fair School Other
EDUCATION
High School: Did you graduate? Yes No Street Address: City:    State:    Zip:   Degree/Area of Study:    Years Attended:  College: Did you graduate? Yes No Street Address: City:    State:    Zip:  Degree/Area of Study:    Years Attended:  Graduate School: Did you graduate? Yes No Street Address: City:    State:    Zip:  Degree/Area of Study:    Years Attended:
U.S. MILITARY SERVICE
Branch:     Specialization:
Rank Attained:
SPECIAL SKILLS
Typing Shorthand CRT Strokes/Hr PC Software or Other Equipment   WPM   WPM   ST/HR
LEGAL
Are you a U.S. citizen or do you have a legal right/necessary documents to work in the U.S.?  Yes  No Were you ever discharged by a company?   Yes No If yes, give name of company(ies):   Reason for discharge:   Have you ever been convicted of a crime other than a minor traffic violation? The existence of a criminal record will not automatically disqualify you from the job for which you are applying. Yes No If yes, please explain offense/final disposition:
EMPLOYMENT HISTORY
List employment starting with your most recent position. Account for any time during this period that you were unemployed by stating the nature of your activities. Please indicate if you were employed under a different name.

May we contact your present employer?  Yes No       Past employer?  Yes No

DATES Employer #1 Supervisor From To Address:  City: State:    Zip:    Phone:  Position Held:    Salary: Major Duties:  Reason for leaving:    DATES Employer #2 Supervisor From To Address:  City: State:    Zip:    Phone:  Position Held:    Salary: Major Duties:  Reason for leaving:    DATES Employer #3 Supervisor From To Address:  City: State:    Zip:    Phone:  Position Held:    Salary: Major Duties:  Reason for leaving:    DATES Employer #4 Supervisor From To Address:  City: State:    Zip:    Phone:  Position Held:    Salary: Major Duties:  Reason for leaving:

Have you previously worked for Wendy's or any of its subsidiaries or franchisees? Yes No

If so, please list location:

Address:   City:

State:   Zip:    Supervisor:

Position Held: Dates From:   To:

Reason for leaving:

REFERENCES

Business References (do not list relatives):

BUSINESS REFERENCE #1

Name:   Work Phone:

Address:    City:

State:    Zip:   Title:    Yrs. Known:

BUSINESS REFERENCE #2

Name:   Work Phone:

Address:    City:

State:    Zip:   Title:    Yrs. Known:

BUSINESS REFERENCE #3

Name:   Work Phone:

Address:    City:

State:    Zip:   Title:    Yrs. Known: