Employment Application - Restaurant New Hire Application Form (Page 2 of 2) in pdf

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DO YOU HAVE ANY RELATIVES EMPLOYED WITH OUR COMPANY?

YES

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IF YES, LIST NAMES AND POSITIONS______________________________________________________________________________

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HAVE YOU EVER BEEN CONVICTED OF A CRIME? YES

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________________________________________________

IF YES, PLEASE LIST THE DATE, PLACE, CHARGE, & DESPOSITION*: _____

*You need not disclose a conviction a) that was judicially expunged or sealed b) for a marijuana-related offense over 2 years old; c) if you completed a

pre- or post- trial diversion program; or, d) for a misdemeanor for which probation was successfully completed (or discharged) and the case was

judicially dismissed. A conviction will not necessarily be a bar to employment.

EDUCATION

CIRCLE HIGHEST GRADE COMPLETED:

1 2 3 4 5 6 7 8 9 10 11 12

COLLEGE 1 2 3 4 5 6 7

DEGREE(s) / LICENSE(s) HELD____________________________________________________________________________________

NAME OF LAST SCHOOL ATTENDED_______________________________________________________________________________

OTHER TRAINING OR TRADE SCHOOL_____________________________________________________________________________

WHICH COMPUTER PROGRAMS and / or POINT OF SALE SYSTEMS CAN YOU OPERATE? _________________________________

______________________________________________________________________________________________________________

OTHER KNOWLEDGE, SKILLS, OR ABILITIES________________________________________________________________________

PERSONAL REFERENCES

List the two individuals who will act as personal references. Do not list family members.

Name

Telephone

Relationship

1._____________________________________________________________________________________________________________

2._____________________________________________________________________________________________________________

REFERRAL SOURCE

How did you hear about the position you are applying for: Internet ______ Newspaper _______ Friend _______ Other ____________

If you were referred by an employee, please print their name here: ________________________________________________________.

ACKNOWLEDGEMENTS

PLEASE READ CAREFULLY, INITIAL EACH PARAGRAPH AND SIGN BELOW.

____I certify that the statements I have made on this application are true and correct. I understand that any misrepresentations made in this

application will be sufficient cause for denial of employment with or discharge from The Company. I understand that nothing contained in this

application, or the granting of an interview, is intended to be a contract of employment. I also understand that employment with The Company

is “at-will” and that either of us may terminate the relationship at any time, for any reason, with or without cause. I certify that if employed by

The Company, I will abide by all company rules and regulations.

____I authorize The Company to investigate my background to determine my suitability for employment and use any information lawfully

obtained for any employment-related purpose permitted by law. This investigation may include checking with the schools and employers I

have identified, reviewing criminal conviction and driving records, and verifying any other relevant information about me. I release and waive

any claims I may have against and indemnify The Company and any of the schools, former employers and other persons or entities for any

loss or injury I may sustain as a result of any disclosure made related to this application.

____The use, possession, or being under the influence of illegal drugs or alcohol while on Company time is prohibited and will result in

disciplinary action, up to and including termination of employment. I hereby agree to any lawful drug or integrity testing or post-offer medical

examination that may be required as a condition of employment and understand that refusal to submit to such testing during the course of my

employment may result in disciplinary action, up to and including discharge. I authorize any physician, hospital, laboratory or collection site to

release to The Company the results of any test or examination or other information which may be necessary to determine my ability to perform

the duties of a job for which I am being considered, prior to employment or in the future during my employment with The Company.

We are an equal opportunity employer. Government Agencies require reports on status of applicants. This data is for analysis and affirmative

action only. Submission is voluntary. Failure to supply this information will not jeopardize or adversely affect any consideration you may receive

for employment, or later advancement in employment.

0-White 1-African America 2-Asian/Pacific Islander 3-American Indian 4-Hispanic 5-Decline to State 6-Unknown

Designation Indicating Race: _______

Enter number here. Thank you.

Date:

Signature:

Employment Application - Restaurant New Hire Application Form Page 2

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