NATC Donuts, Inc.

705 Boulevard, Kenilworth, NJ 07033 • 534 Boulevard, Kenilworth, NJ 07033 • 421 Central Avenue Westfield, NJ 07090
196 Westfield Avenue, Clark, NJ 07066 • 547 Inman Avenue, Colonia, NJ 07067 • 320 Chestnut Street, Union, NJ 07083
926 St. Georges Avenue, Rahway, NJ 07065 • 1659 St. Georges Avenue, Rahway, NJ 07065 • 2639 Morris Avenue, Union, NJ 07083
1401 Morris Avenue, Union, NJ 07083 • 1230 Raritan Road, Cranford, NJ 070161 • 976-7 Inman Avenue, Edison, NJ 08818
323 North Avenue, Garwood, NJ 07027 • 333 North Avenue East Cranford, NJ 07016 • 8 Ashwood Avenue Summit, NJ 07901
1982 Morris Avenue, Union, NJ 07083 • 545 Morris Avenue, Summit, NJ 07901 • 76 Central Avenue (Shop Rite), Clark, NJ 07066
6-20 South Avenue West Cranford, NJ 07016 • 777 Walnut Avenue Cranford, NJ 07016

APPLICATION FOR EMPLOYMENT

Personal Information   Date
Name
Present Address
City State
Zip Code    
       
Permenant Address    
City State
Zip Code    
       
Phone Referred By
       
Employment Desired      
Position Start Date
Salary Desired    
Are You Employed?
   
If yes, may we contact
your present employer?
   
Ever applied to
this company before?
   
When? Where?
In which store locations can you work?
(see list above)
   
Are you legally
authorized to work
in the United States?
(Identity and employment eligibility of all new hires will
be verified as required by the Immigration Reform and Control Acts of 1986)
Are you 18 years
or older?
   
Have you ever
been discharged by
a company?
If yes, give name(s) of company?
Reason for discharge    

Federal, State and local laws prohibit discrimination based on race, color, sex, religion, affectual or sexual orientation, national origin, ancestry,
age, physical or mental disability that does not affect ability to perform essential job function(s) with or without reasonable accommodation,
or any other protected status not listed in this statement. Your application will be considered in full accord with applicable Federal, State and
local requirements.

       
Availability      
Check One    
Days Available From/To
  From/To
  From/To
  From/To
  From/To
  From/To
  From/To
       
Education History      
Grammar School Years?
Subjects Studied? Graduated?
       
High School Years?
Subjects Studied? Graduated?
       
College Years?
Subjects Studied? Graduated?
       
Trade, Business, Other Years?
Subjects Studied? Graduated?
       
General Information      
Subjects of special
study, research work,
or special training
or skills
   
US Military Service (branch) From/To
Rank at discharge    
       
Former Employers      
Name/Address of Employer Salary

Position


Reason for leaving    
       
Name/Address of Employer Salary

Position


Reason for leaving    
       
Name/Address of Employer Salary

Position


Reason for leaving    
       
References      
Name Years Known
Address Business
       
Name Years Known
Address Business
       
Name Years Known
Address Business
       
Authorization      

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed,
falsified statements on this application or during my interview shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information
concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from
all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment
for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by
an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by
the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

I understand that I am applying for work with (one or more) Dunkin’ Donuts Franchisees, and not Dunkin’Brands, Inc. or any of its affiliates.
If hired the Franchisee will be my only employer. Franchisees are independent business people who set their own wage and benefit programs
that can vary among Franchisees.

Signature Date
     
Interviewed By Date


Thank you for your interest in applying to Dunkin Donuts. In order for you to send the application, please enter the
information below and hit submit.

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