Application for Employment

Personal:

First Name:
Middle Initial
Last Name:
Address:
City:
State:
Zip Code:
Telephone:
Social Security Number
If you are under 18 years of age, could you furnish a work permit?	Yes No N/A
Are you legally eligible for employment in this country? (Proof of U.S. Citizenship or immigration status will be required upon employment.)	Yes No

Restaurant Experience (Please check any prior restaurant experience)

Management	Waiter/tress
Bartender	Cook
Chef	Host/Hostess
Bus/Dishwasher	Deliveries
Cashier	Catering
Banquets	Bookkeeping
Other
Please specify:

Position(s) Applying for:
Have you ever been employed by this Restaurant before?	Yes No
Are you currently employed?	Yes No
May we contact your current employer?	Yes No
If a position requires travel, do you have a valid drivers license?	Yes No
Have you ever been convicted of a felony in the last seven (7) years? (conviction will not automatically disqualify an applicant from employment)	Yes No
If Yes, please explain:
List any special skills, experiences, or qualifications which may benefit you in the job for which you are applying:

Availability - List hours available to work per week:

Monday	From to
Tuesday	From to
Wednesday	From to
Thursday	From to
Friday	From to
Saturday	From to
Sunday	From to
	Full-Time Part-Time

Educational Background:

High School

School Name and Address:
Years Completed
Diploma Degree
Subjects Studied

College

School Name and Address:
Years Completed
Diploma Degree
Subjects Studied

Graduate School

School Name and Address:
Years Completed
Diploma Degree
Subjects Studied

Trade, Business or Vocational School

School Name and Address:
Years Completed
Diploma Degree
Subjects Studied

Employment History - List the last 3 employers, starting with the last one first. Include any volunteer activities or military experience.

1. Name and Address of Employer:
Telephone:
From Date:
To Date:
Job Title:
Supervisor:
Describe Major Duties:
Reason for Leaving:
Starting Salary:
Final Salary:

2. Name and Address of Employer:
Telephone:
From Date:
To Date:
Job Title:
Supervisor:
Describe Major Duties:
Reason for Leaving:
Starting Salary:
Final Salary:

3. Name and Address of Employer:
Telephone:
From Date:
To Date:
Job Title:
Supervisor:
Describe Major Duties:
Reason for Leaving:
Starting Salary:
Final Salary:

References - List the names of three persons, not related to you, who have known you for at least two years.

Reference One
Name:
Address:
Occupation:
Telephone:

Reference Two
Name:
Address:
Occupation:
Telephone:

Reference Three
Name:
Address:
Occupation:
Telephone:

Pre-Employment Statement

"I certify that all the information submitted by me on this application form is true and complete. I authorize investigation of all statements contained on this application form and permit this organization to obtain any transcripts, records, or documents pertaining to my education, backgroun, or business experience. I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected or if I am employed, my employment may be terminated at any time. If an employments relationship is established, I understand that I retain the right to terminate my employment at any time and that this organization retains the same right. I also understand that my terms of employment can be changed at any time, with or without cause or notice, by this organization. I also understand that I am required to abide by all rules and regulations of this employer."

Electronic Signature (please type initials)