Take a picture of your state issued photo ID to upload
*
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Take a picture of your 2nd form of ID to upload.
*
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Are you a minor?
*
Yes
No
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Take a picture of your work permit to upload.
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First Name
*
Middle Initial
Last Name
*
Other Last Name Used (If Any)
Social Security Number
*
Street Address
*
City
*
State
*
Zip Code
*
County You Live In
*
Date Of Birth
*
-
Month
-
Day
Year
Date
Applicant
Applicant
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Todays Date (Will Autofill)
*
-
Month
-
Day
Year
Date
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McDonald's Location Working At (For Employer Name Purposes)
*
Please Select
Beverly (PFRIII, Inc.)
McConnelsville (PFRIV, Inc.)
McDonald's Location Working At (Again)
*
Please Select
Beverly (86-3756416)
McConnelsville (86-3774231)
Employer Address & Phone Number
Street Address of employer
City State Zip of employer
Have you worked for this employer before?
*
Yes
No
If yes, what was your last date of employment?
-
Month
-
Day
Year
Date
What is your starting wage? If you are unsure, ask your manager.
*
What is your position? (crew, manager, or maintenance)
*
Are you at least 16, but under age 40?
*
Yes
No
Are you a Veteran of the U.S. Armed Forces?
*
Yes
No
Are you a member of a family that received Supplemental Nutrition Assistance Program (SNAP) benefits (Food Stamps) for at least 3 months during the 15 months before you were hired?
*
Yes
No
If yes, what is the name of the primary recipient?
If yes, what is the city and state benefits were received?
Are you a veteran entitled to compensation for a service-connected disability?
*
Yes
No
Were you discharged or released from active duty within a year before you were hired?
Yes
No
Were you unemployed for a combined period of at least 6 months (whether or not consecutive) during the year before you were hired?
Yes
No
Are you a member of a family that received Supplemental Nutrition Assistance Program (SNAP) (formerly Food Stamps) benefits for the 6 months before you were hired?
*
Yes
No
Have you received SNAP benefits for at least a 3-month period within the last 5 months but are no longer receiving them?
*
Yes
No
If yes, what was the name of the recipient?
If yes, what is the city and state benefits were received?
Were you referred to an employer by a Vocational Rehabilitation Agency approved by a State?
*
Yes
No
Were you referred to an employer by an employment network under the ticket to work program?
*
Yes
No
Were you referred to an employer by the department of veteran affairs?
*
Yes
No
Are you a member of a family that received TANF assistance for at least the last 18 months before you were hired?
*
Yes
No
Were you a member of a family that received TANF benefits for any 18 months beginning after August 5, 1997, and the earliest 18-month period beginning after August 5,1997, ended within 2 years before you were hired?
*
Yes
No
Did your family stop being eligible for TANF assistance within 2 years before you were hired because of a Federal or state law limited the maximum time those payments could be made?
*
Yes
No
Are you a family that receive TANF assistance for any 9 months during the 18-month period before you were hired?
*
Yes
No
If yes, name of primary recipient?
If yes, city and state benefits were received?
Were you convicted of a felony or released from prison after a felony conviction during the year before you were hired?
*
Yes
No
If yes, date of conviction?
If yes, date of release?
If yes, was it state or federal conviction?
Federal
State
Do you live in an empowerment zone?
*
Yes
No
Do you live in an empowerment zone and are at least age 16, but not yet 18?
*
Yes
No
Did you received Supplemental Security Income (SSI) benefits for any month ending within 60 days before you were hired?
*
Yes
No
Are you a veteran unemployed for a combined period of at least 6 months (whether or not consecutive) during the year before you were hired?
*
Yes
No
Are you a veteran unemployed for a combined period of at least 4 weeks but less than 6 months, whether or not consecutive, during the year before you were hired?
*
Yes
No
Are you an individual who is or was in the period of unemployment that is as least 27 consecutive weeks and for all or part of that period you received unemployment compensation?
*
Yes
No
If yes, what state did you receive unemployment compensation in?
Check all that apply
Check here if you received a condiditional certification from the state workforce agency or a participating local agency for the work opportunity credit.
Check here if any of these apply to you: I am a member of a family that has received assistance from TANF for any 9 months furing the past 18 months; I am a veteran and a member of a family that received SNAP benefits (food stamps) for at least a 3 month period during the last 15 months; I was referred here by a rehabilitation agency approved by the state, an employment network under the ticket to work program or the department of veteran affairs; I am at least 18 but not age 40 or older and I am a member of a family that received SNAP benefits for the last 6 months OR received SNAP benefits for at least 3 months of the past 5 months but no longer eligible to receive them; During the past year, I was convicted of a felony or released from prison for a felony; I received SSI for any month ending during the past 60 days; I am a veteran and I was unemployed for a period or periods totaling at least 4 weeks but less than 6 months during the past year.
Check here if you are a veteran and you were unemployed for a period or periods totaling at least 6 months during the past year
Check here if you are a veteran entitled to compensation for a service connected disability and you were discharged or released from active duty in the US Armed Forces during the past year
Check here if you are a veteran entitled to compensation for a service connected disability and you were unemployed for a period or periods totaling at least 6 months during the past year.
Check here if you are a member ofo a family that: received TANF payments for at least the past 18 months OR received TANF payments for any 18 months beginning after August 5 1997 and the earliest 18 month period beginning after August 5 1997 ended during the past 2 years OR stopped being eligible for TANF payments during the past 2 years because federal or state law limited the maximum time those payments could be made.tion 6
Check here if you are in a period of unemployment that is at least 27 consecutive weeks and for all or part of that period you received unemployment compensation.
I attest, under penalty or perjury, that I am:
*
A citizen of the United States
A noncitizen national of the United States
A layful permanent resident
An alien authorized to work
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Uniform Request Form
Make sure you scroll inside the form and hit the purple SUBMIT button
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W4 Tax Filings
*
Single or Married Filing Separately
Married filing jointly or qualifying widow
Head of household
Multiply the number of qualifying children under age 17 by $2,000. If none, put 0.
*
Multiply the number of other dependeents by $500. If none, put 0.
*
Dependent Total
Other income (not from jobs). If none, put 0.
*
If you want any extra withholdings per pay period, enter that amount here. If none, put 0.
*
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Direct Deposit Bank Name
Direct Deposit Routing Number
Direct Deposit Account Number
I have read this Employee Handbook carefully and I accept all of the rules, policies, regulations and responsibilitiesset forth herein. I recognize that this Handbook does not constitute a contract of employment, oral or written, nor aguarantee of benefits or compensation.I understand that my employment is at will and for no set period of time and can be modified or terminated, with orwithout cause and with or without prior notice at any time, at the option of either company or myself.I further recognize that the company reserves the right to change the policies, procedures and benefits set forth inthis handbook, either with or without notice, and that the changes can be made either in writing or orally. However,the president of the company can only make such changes.I understand that no representative of the company other than the president has an authority to enter into anyagreement for employment for a specified period of time or to make any agreement contrary to the foregoing, exceptthat the president of the company may do so in writing
*
Type a question
Submit
Submit
Should be Empty: