Employment Application An Equal Opportunity Employer M/f - J.alexander'S Page 3
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4PERSONAL REFERENCES:
List three persons who have known you at least two years. Not former employers
or relatives.
1. _____________________________________________________________________________________________________
Name
Address
Occupation
Phone
2. _____________________________________________________________________________________________________
Name
Address
Occupation
Phone
3. _____________________________________________________________________________________________________
Name
Address
Occupation
Phone
In case of emergency, notify:
____________________________________________
_____________________________________________________________________________________________________
Street
City
State
Zip
_____________________________________________________________________________________________________
Relationship
Phone
THE POSITION FOR WHICH YOU ARE APPLYING MAY REQUIRE THE FOLLOWING ACTIVITIES:
Standing for long periods
Stooping
Continuous walking
Squatting
Regularly lifting
Twisting or turning
Writing (Mgmt., serving, administration)
Raising arms above head
Working under stress
Bending
Work that could increase your heartbeat rate
__________
Can you perform these functions with or without a reasonable accommodation?
PLEASE WRITE A BRIEF EXPLANATION AS TO WHY YOU WANT TO WORK AT J. ALEXANDER’S:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
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Parent category: Business