Jimmy John’s Employment Application

1 Jimmy john s Employment ApplicationPERSONAL INFORMATIONLast NameFirst NameMIDo you have any relatives working for this Jimmy john s store? Yes NoIf Yes , give name, relationship, PhoneCell PhoneReferred By: Newspaper/Advertisement Individual Gov t Agency Employment Agency College OtherCityStateZip CodeHave you ever been employed by this or any other Jimmy john s store? Yes NoIf Yes , please complete this line: Mo Yr Mo YrDate of Employment From: / To: / Name of SupervisorLocationPosition DesiredEmployment Desired Full Time Part TimeHours AvailableFromToMTWTFS SAre you under 18 years of age?

2 Yes NoIf Yes please provide birth date. / / Have you ever been convicted of a felony? Yes NoIf Yes , explain:EDUCATION (Name & Address of School)MajorNo of YrsDipl/DegreeSignatureCollegeI certify that the information contained in this Application is correct to the best of my knowledge and understand that falsifi cation of this information is grounds for dismissal in accordance with Jimmy john s Enterprises, LLC. I authorize the references and supervisors 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 all parties from all liability for any damage that may result from furnishing same to you.

3 In consideration of my Employment , I agree to conform to the rules and regulations of Employer and that my Employment and compensation can be terminated at any time with or without cause, at the option of either the company or myself. I understand that no representative of Employer other than the President has the authority to enter into any agreement for Employment for any specifi ed period of time, or to make any agreement contrary to the SchoolOtherEMPLOYMENT (list most recent job fi rst)CompanyAddressName of SupervisorJob Title/Duties PerformedPhone # (Area Code)( )FromMo.

4 For LeavingStarting PayEnding PayCompanyAddressName of SupervisorJob Title/Duties PerformedPhone # (Area Code)( )FromMo. for LeavingStarting PayEnding PayCompanyAddressName of SupervisorJob Title/Duties PerformedPhone # (Area Code)( )FromMo. for LeavingStarting PayEnding PayMAY WE CONTACT YOUR PRESENT EMPLOYER? Check One ( ) Yes NoPERSONAL REFERENCES (Not former employers or relatives)NameRelationship or TitlePhone # (Area Code)( )NameRelationship or TItlePhone # (Area Code)( )Please Print An Equal Opportunity EmployerTHIS SIDE TO BE COMPLETED BY APPLICANTUNSHADED AREAS ON THIS SIDE TO BE COMPLETED BY EMPLOYEE AFTER Employment (NOT AT TIME OF Application )FILL OUT AT TIME OF HIRE ONLYEMPLOYEE S PERSONAL DATAEQUAL Employment OPPORTUNITY CODE Caucasian African American Hispanic Asian American Native or Alaskan Native SEX Female MaleLEGAL MARITAL STATUS (CHECK ONLY ONE)

5 Single Married Legally Separated Divorced Widowed EMPLOYEESPOUSE INFORMATIONEMERGENCY CONTACTMILITARY INFORMATIONF amiliar Name:FirstMILastLast NameRelationshipSel Serv. StatusARE YOU A CITIZEN? Yes NoFirst NameBranch NO, COUNTRY OF CITIZENSHIP:Apt/PO BoxPhone EnteredDate DischargedFOREIGN LANGUAGES treetOccupational SkillCodeLanguage(s) Profi ciency Level Verbal Written Both Verbal Written BothCityStZi