> CONTACT INFORMATION

First Name: Last Name:

Current Address:

City: State: ** State Name ** Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Contact Phone Number: Cell:

Email Address:

Please indicate level of education:

Some high school Graduated high school Some college Bachelor's

> EMPLOYMENT PREFERENCES

If hired today, what date could you start employement?

Are you interested in a full-time position? Yes No

Are you available to work nights? Yes No

Can you provide verification of your legal right to work in the US? Yes No

Do you have a valid drivers licence (for driving positions only)? Yes No

Have you been convicted of any moving violations in the past five years?

Yes No

Will you submit to a criminal background & drug test is you are offered the position?

Yes No

Have you every been convicted of, or pleaded guilty to, a felony offence within the last seven years? Yes No

Have you ever been discharged from a job due to misconduct? Yes No

Have you ever worked for RDP Foodservice before? Yes No (If yes, please give the dates)

Are you at least 18 years of age? Yes No

What type of position are you seeking?

Paste resume (if available):