Chipotle

Employment Application
Applicant Information
Full Name:

Faulk
Last

Address:

Tremel

Dejuan

First

M.I.

Date:2/22/16

4201 Tate Ave Adamsville, Al

Street Address

Phone:

Apartment/Unit #

Birgmingham

AL

35005

City

State

ZIP Code

(205) 545-0898

Date Available:

ASAP

EmailTremelFaulk @jcode.k12.al.05
Social Security No.:

Desired Salary:$8.50

Position Applied for: Server

Are you a citizen of the United States?
Have you ever worked for this company?
Have you ever been convicted of a felony?

YES

NO

YES

NO

YES

NO

If no, are you authorized to work in the U.S.?

If yes, when?N/A

If yes, explain: N/A

Education
High School:
From:

2015

Minor High School

To:

College:
From:
Other:

Address:2285 Minor Pkwy, Adamsville AL 35005

Did you graduate?

YES

NO

YES

NO

Diploma::

Address:
To:

Did you graduate?

Address:
1

Degree:

YES

NO

Chipotle
From:

To:

Did you graduate?

YES

NO

Degree:

References
Please list three professional references.
Full Name: Bernice Anderson

Relationship:Mom

Company:

NCA

Phone:(205) 236-0986

Address:

4201 Tate Ave Adamsville AL

Full Name: Lamar King

Relationship:Cousin

Company:

NBA

Phone:(205) 764-9565

Address:

4374 Mohawk Ave Forestdale AL

Full Name: Dewright Spencer

Relationship:Uncle

Company:

NCA

Phone:(205) 645-8299

Address:

8201 Clen Drive Roebuck AL

Previous Employment
Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Company:

Phone:

Address:

Supervisor:

Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

Company:

NO

Phone:

Address:

Supervisor:
2

Chipotle
Job Title:

Starting Salary:$

Ending Salary:$

Responsibilities:
From:

To:

Reason for Leaving:

YES

May we contact your previous supervisor for a reference?

NO

Military Service
Branch:

From:

Rank at Discharge:

To:

Type of Discharge:

If other than honorable, explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or
interview may result in my release.

Signature:

Tremel Faulk

Date:2/22/16