Jamba Juice Online Application v.1

Today's Date *

Phone number *

Email address *

Full Legal Name *

Middle initial

Street Address *

City *

State *

Zip code *

Are you at least 16 years of age? *

Minors age 16 or 17 must be able to provide a Certificate of Age at the time of hire.

If No

If hired, can you provide proof of eligibility to work in the United States prior to your start date? *

Last four digits of Social Security number *

Emergency contact name *

Emergency contact phone number *

Emergency contact address


High School name and location *

No. of years attended

Currently attending *

Graduated? *

College/Technical name and location

No. of years attended?

Currently attending?

Graduated?

What will you bring to our team at Jamba Juice? *

List your special skills, activities or community involvement you feel are pertinent to the job you’re applying for: *


Have you ever been denied a driver’s license, or had your license revoked or suspended? *

If yes, please explain:

Have you previously worked for JJC Hawaii, or JIB Hawaii? *

If yes, dates?

Location:

Reason for leaving

Name of Immediate Supervisor:

Were you referred by an existing employee to apply? *

If yes, what is their First and Last name

Have you previously applied with JJ Hawaii or JIB Hawaii? *

Are you able to perform all the essential functions of the job for which you are applying with or without accommodation? *

If No, please explain


What led you to contact us for employment? *

Date available for employment: *

Position(s) desired: *

Location(s) desired: *

Oahu - First Choice

Oahu - Second Choice

Oahu - Third Choice

Big Island

Maui - First Choice

Maui - Second Choice

Maui - Third Choice

Kauai

How many hours are you available to work each week? *

Shifts available: Monday *

Shifts available: Tuesday *

Shifts available: Wednesday *

Shifts available: Thursday *

Shifts available: Friday *

Shifts available: Saturday *

Shifts available: Sunday *

If hired is there anything that may prevent you from reporting to work each scheduled day on time? *

If yes, please explain


Have you ever worked before? *

Begin with your most recent employer and account for your last three jobs or the last 7 years, whichever is shorter. If you worked under a different name, please indicate.

1) Employer's Name

Street Address

City

Phone

State

Zip Code

Dates of employment (Monday/Day/Year)-(Month/Day/Year)

Position/Duties

Full time/ Part time?

Name of immediate supervisor

May we contact this reference?

Reason for leaving?

Starting Pay

Current Pay

2) Employer's Name

Street Address

City

Phone

State

Zip Code

Dates of employment (Monday/Day/Year)-(Month/Day/Year)

Position/Duties

Full time/ Part time?

Name of immediate supervisor

May we contact this reference?

Reason for leaving?

Starting Pay

Ending Pay

3) Employer's Name

Street Address

City

Phone

State

Zip Code

Dates of employment (Monday/Day/Year)-(Month/Day/Year)

Position/Duties

Full time/ Part time?

Name of immediate supervisor

May we contact this reference?

Reason for leaving?

Starting Pay

Ending Pay


Name 1st of Professional Reference

Relationship

Years Acquainted

Phone number

Name of 2nd Professional Reference

Relationship

Years Acquainted

Phone number

Name of 1st Personal Reference *

Relationship *

Years Acquainted

Phone number *

Name of 2nd Personal Reference *

Relationship *

Years Acquainted

Phone number *


This space is provided for your use in giving us any information about yourself not already covered by this form; e.g. career interests, plans, objectives, or any other information about yourself that you feel we should know when considering you for this position.

Please read the following paragraphs very carefully before signing this application. I certify that to the best of my knowledge and belief, that statements made by me is this application are correct and complete without omission of any kind. I understand that any false information I give when applying for employment, whether in this application or otherwise, will cause termination of my employment, regardless of when discovered. You are hereby authorized to investigate all the statements made in this application, except for any information about disability and medical conditions or treatment, which is prohibited by the Americans With Disabilities Act. I further agree that I do not have an employment contract and that my employment can be terminated or modified with or without notice or cause at any time by the company or me. *

JJC HAWAII, LLC hires only U.S. citizens and lawfully authorized alien workers. Your name and social security number will be verified with the Social Security Administration. The law prohibits discrimination because of race, color, religion, sex, age, national origin, sexual orientation, ancestry, marital status, arrest and court record, or a disability which may be reasonably accommodated. *

DRUG TESTING NOTICE TO ALL APPLICANTS This notice is to inform you that JJC Hawaii LLC promotes a drug-free work environment. If a job offer is extended to you, you may be required to submit to and pass a drug test for the abuse of illegal substances prior to being hired, following a work-related injury, prior to finalizing a promotion, on a periodic basis testing basis and/or on a random testing basis. Employment with JJC Hawaii LLC is also conditioned upon your agreement to submit any claims or controversies arising out of your employment to arbitration pursuant to the JJC Hawaii LLC Dispute Resolution Agreement, and your agreement to keep company information confidential pursuant to the JJC Hawaii LLC Confidentiality Agreement. *