Last Name

First Name

Location You Are Applying For *

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?

Yes

What position are you applying for?

Are you at least 16 years old?

If under 18, hire is subject to verification that you are of minimum legal age.

Yes

Have you ever been employed by this restaurant before?

Yes

If yes, when?

Have you ever been convicted of a criminal offense (felony or serious misdemeanor)?

Yes

If yes, state nature of the crime(s), when and where convicted, and disposition of the case:

The following convictions should not be listed: i) conviction records that have been sealed or expunged by court order or statutorily eradicated, ii) misdemeanor convictions for which you have successfully completed or otherwise discharged probation, iii) misdemeanor marijuana convictions if the conviction occurred more than two years ago, iv) any conviction as to which the conviction or release from prison, whichever is more recent, occurred more than 10 years ago.

Education

High School

Name of School and Address Number of Years Did you graduate? Diploma or Degree

College

Name of School and Address Number of Years Did you graduate? Diploma or Degree

Other School

Name of School and Address Number of Years Did you graduate? Diploma or Degree

Employment History

Company 1

Dates of Employment (from - to): Company Type of Business Position Held Duties and Responsibilities Address Phone Supervisor Salary/Commission Reason for Leaving Other

Company 2

Dates of Employment (from - to): Company Type of Business Position Held Duties and Responsibilities Address Phone Supervisor Salary/Commission Reason for Leaving Other

If you are currently employed by any of the employers listed, may we contact them?

Yes

References

List two school, work, or personal references we may contact. Do not list family members.

Reference 1

First name, Last name, Telephone number

Reference 2

First name, Last name, Telephone number

Additional Info

How did you hear about us?

When are you available for work?

Days

Nights

Part Time

Full Time

Weekends

Holidays

Do you have reliable transportation to get to work?

Yes

In case of emergency, notify:

Name, Phone

Additional information you would like us to consider:

All persons hired will be expected to attend an orientation meeting prior to starting in the restaurant as a condition of employment.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize the company, and any agent its designates, to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I understand that the company has installed or may install surveillance cameras in the restaurant for safety and security purposes and may otherwise video-tape and/or record my performance and interaction with others in the restaurant for training and evaluation purposes at the Company. By signing below, I consent to such surveillance, video-taping, and recording, and consent to use of such video-tapes and/or recordings at the Company for training and evaluation purposes.

I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's owner.

By typing in your name, date, and submitting your application you are agreeing to all of the terms outlined above.

Signature

Type your full name

Signature Date

YYYY

Application for Employment

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