An Equal Opportunity Employer

Merrill Theatre Cinema Corporation
Merrill's Roxy Cinemas

Application for Employment

Personal Information

Name

_______________________________________________________________
last,                                       first,                                        middle initial


Telephone  #


(____) _____ ____________

Address

_________________________________________________________
street, box, apt #,

 _________________________________________________________
city, state, zip

Social Security #

________________________  Are You under 18 or over?________


Employment		 If not, are you 16 or 17_______

Position Applied for:

________________________________

 Full Time____ Part-time____ Either____
Date Available to Start____________________ Available hours for work:________________
Check off below all shifts you are available to work
(Note: weekend availability is in most circumstances required)
Mon Night
  
Tues Day
Tues Night
Weds Day
Weds  Night
  
Thurs Day
Thurs Night
Fri Day
Fri  Night
  
Sat Day
Sat Night
Sun Day
Sun  Night
  Salary Desired? ___________ /an hour
 Are you legally able to work in the US?  ____yes ____ no

Have you ever worked for a movie Theatre?_____ yes _____ no    If yes please circle which one below
Merrill Theatres         Hoyts Cinemas        Essex Outlet Cinemas        Regal

Other (write in theatre name)______________________

List the names of any relatives or friends Currently employed by Merrill Theatres:

_______________________________   _______________________________


References    

Give below the names of three persons not related to you whom you have known at least one year
 

Name & Address

Business

Years Known

___________________________________________ ______________ ______________  
___________________________________________ ______________ ______________  
______________________________________ ____________ ____________  

Job History     List all prior employers, position held and length of job.
 

Date
Month and Year

Name & Address
of Employer

Salary

Position

Reason for Leaving

From
To
 
 
 
 
From
To
 
 
 
 
From
To
 
 
 
 


Education     List your education:

Name of School Location Major Graduate Y/N
___________________________________________ _______________ _____________ _________
___________________________________________ _______________ _____________ _________
______________________________________ _____________ ____________ ________

List hobbies or outside interests: ___________________________________________________________________________

I certify, by my signature below, that making a false representation anywhere in this application will be cause for not hiring me or terminating my employment if already hired when the false statement is discovered. I also release any and all prior employers from any/all liabilities associated with providing Merrill Theatre Corp with information about my prior employment with those employers. I hereby grant express permission to those prior employers to provide Merrill Theatre Corp with information as to positions held, length of employment, rates of pay, and why my employment was terminated. I also understand I must reapply every 6 months if not yet hired.
_____________________________________ (Signature of applicant) ______________(Date)