Please fill out all information as detailed and accurately as possible.
 
Personal Information
 
First Name:
 Middle Name:
 Last Name:
SSN:
Address:
 City:
 State:
 Zip:
Email:
 Primary Phone:
 Secondary Phone:
 Referred By:
 
Employment Desired
 
Positions Desired:
 Desired Start Date:
 Desired Salary:
 
Education History
 
Name/Location What Years Graduate? Subjects
High School             
College             
Grad School             
Trade School             
Other School             
 
General Information
 
Subjects of special study/research work of special training/skills
US Military or Naval Service
 Rank


 
Former Employers
Begin with current/most recent
 
From(mm/yy) To(mm/yy) Name/Address Phone Salary Position Reason Left
1.
2.
3.
4.
5.
 
Work References
At least 3. Please no friends or family friends
 
Name Address Phone Business Years Known
1.
2.
3.
4.
5.
6.
7.
 
Pre-Interview Questions
 
1. Why are you looking for a job?
2. What type of employment are you seeking, and for what days and hours are you looking?
3. Have you ever been fired, or left a job on bad terms? Please explain.
4. Have you ever been convicted of, or pled no contest to a felony?
5. Do you have any Management experience? Please explain in detail including duties and responsibilities.
6. Do you have any other obligations now or soon in the future? (Other job, school, clubs, organizations, etc.)
7. Do you have any trips planned? Please include relevant dates scheduled.
8. What other restaurant/bar experience do you have that might be of value to you here? (Such as experience in other positions)
9. What other work experience in general do you have that you feel might be of value to you here?
10. How do you feel you could contribute to this organization as an employee here?

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Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information they may have, personal or otherwise, and release the company from all liability for any damage that mat result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."


Signature (Full Name)

This digital signature is representative of your normal signature and is binding as agreement to the Authorization paragraph above.