Employment Application

Personal Information
Name*
First Last
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Main Phone*
Email*
Are you 18 years of age or older?*
- Yes
- No
Are you authorized to work in the United States?*
- Yes
- No
What languages can you speak?
Have you ever been convicted of a felony?*
- Yes
- No
Please provide details:

Employment Desired
Restaurant Location*
Position
Hourly Wage Desired
Date you can start*
What is your availability?*
Do you have reliable transportation?*
- Yes
- No
Are you currently employed?*
- Yes
- No
If so, may we contact your current employer?*
- Yes
- No
Have you ever applied to this company before?*
- Yes
- No

Education
High School
Name and location of school No. of years attended Did you graduate? Subjects studied
College
Name and location of school No. of years attended Did you graduate? Subjects studied
Other
Name and location of school No. of years attended Did you graduate? Subjects studied
General
Any other skills acquired through training or experience that may make you a desirable candidate:

Employment History
Employers*
Click the "+" button to add an additional employer.
Start Date End Date Name and Address of Employer Salary Position Reason for leaving
References
Click the "+" button to add an additional reference.
Name Phone Business Length of Relationship
Emergency Contact Information

Please list two people we can contact in case of emergency. Please provide any alternate phone numbers, email, addresses, or other means we may use to contact these people.
Emergency Contact 1*
Name Address Phone Email
Emergency Contact 2*
Name Address Phone Email
Allergies and Medical Conditions
For your safety, please list any allergies or medical conditions (this information will be used only in emergency).
Click the "+" button to add an additional item.

Finishing Touches

I certify that the information 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 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. I understand and agree that if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice. I understand that no one is hired as a full time employee, and I fully understand that there is no promise of a set number of hours that I am guaranteed to work per week, and that my hours may fluctuate significantly as they are determined to a great degree on the demands of the business. Finally, I understand that I may be asked to take a drug test prior to receiving treatment for a workman's compensation claim to determine liability for medical coverage and wages.

*The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.
Authorization Date*
Signature*
By providing your name in the following fields, applicant agrees to all of the above terms and conditions for application.
First Last
Phone
This field is for validation purposes and should be left unchanged.

We want the best working with us

Step 1 of 5

Personal Information

Employment Desired

Education

Employment History

Emergency Contact Information

Finishing Touches

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