Fuddruckers Application For Employment Page 2
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1
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3In the last seven years have you been convicted or charged or on probation for a criminal offence (misdemeanor or felony)?
Yes
No
If yes, explain:_______________ ________________________________________________________________________
Are you fluent in other languages? ______ If so, please list____________________________________________________
Please list any additional skills, licensees, and/or certificates that are job related:
_________________________________________________________________________________________________________
____________________________________________________________________________________
EDUCATION (attach additional pages if necessary)
No. of
Did you
School Level
Name & Location of School
Major
Years
graduate?
Attended.
High School
College
Trade/Corresp.
School
EXPERIENCE
(list below your last three employers, beginning with the most recent employer)
Previous Employer
Address/Telephone
Dates
Position/ Duties
Hours
Supervisor
Reason for
Week
Leaving
REFERENCES
(include only individuals familiar with your work ability – do not include relatives)
Name
Phone
Name of Business/Address
Years
Known/Relationship
LUBY’S FUDDRUCKERS WILL NOT ENGAGE IN ANY EMPLOYMENT PRACTICES WHICH DISCRIMINATES AGAINST
EMPLOYMENT APPLICANTS BECAUSE OF RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, AGE OR DISABILITY.
AUTHORIZATION
Equal Opportunity Employer
HR Form No. 201(revised 09/2002, 08/2007, 09/2010) Emp App
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Parent category: Business