Fillable Hourly Application For Employment printable pdf download

Hourly Application for Employment

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In compliance with Federal, State, and Local equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, national origin, religion,

sex, sexual orientation, age, genetic information, or disability. Please answer all questions.

PLEASE NOTE: You will not be able to save information entered into this form. You must print the form once you've completed it.

Last Name

First Name

Middle Name

Zip

Street Address

City

State

Cell Phone

Home Phone

Are you known to schools/references by another name?

If yes, by what name

Yes

Are you

18 or over

16-17

Place a check next to the position(s) you would like to apply for:

server

greeter

dishwasher

prep

cook

buffet

bus person

baker

other

Have you ever been convicted of a felony?

If yes, when and what for?

Yes

Were you previously employed by us or any division of Eat'n Park Hospitality Group?

Yes

If yes, which division, when, and where?

Why did you leave?

List any relatives working for us:

Are you prevented from lawfully becoming employed in this country because of Visa or immigration status?

Yes

Can you perform the essential functions of the job with or without a reasonable accommodation,

or undue risk to your health?

Yes

Previous Employment (list most recent first)

I give Eat'n Park permission to obtain the employment references necessary to make a hiring decision and hold persons giving references free from any and all liability

resulting from this process. I waive any provision impeding the release of this information and agree to provide any information necessary for the release of this information

beyond that provided on the employment application and reference verification form.

Company 1

Name

Address

Phone

From Mo. & Yr.

To Mo. & Yr.

Job Title

Reason for leaving

Supervisor's name/title

Starting rate

Ending rate

Company 2

Name

Address

Phone

From Mo. & Yr.

To Mo. & Yr.

Job Title

Reason for leaving

Supervisor's name/title

Starting rate

Ending rate

Record of Education

High School Name & Address

Years Completed

Graduated

Yes

College/Other Name & Address

Years Completed

Graduated

Degree

Yes

Personal References

Name

Address

Phone

Relationship

Name

Address

Phone

Relationship

I certify that all information on this application for employment is true and correct to the best of my knowledge and belief. I agree that, if employed, any

misrepresentation, falsification or omission of the facts thereon shall justify my dismissal. I understand that neither this document nor any offer of employment

from the employer constitute an employment contract unless a specific document to that effect is executed by the employer and associate in writing.

Signature of applicant ___________________________________________________ Date (Month/Day/Year) ____________________

For Management Use Only. This section to be completed only after hire.

Accommodations requested to perform essential job function(s)?

______________________________________________________