Today's Date (required):

Your Name (required):

Birthdate (required):

Your Email

Address:

Phone: (required):

Position applied for:

Shift Preferred:
AMPMAnytime

Number of hours you would like to work per week:

Are there any hours, shifts or days you cannot or will not work?

If hired, can you provide proof that you are eligible to work in the US? (ex: Driver's License)

Have you been convicted of a felony in the past 10 years? (If yes, this does not automatically disqualify you from employment.)

Are there any special accommodations necessary for you to perform the
requirements of this position?

Why do you want to work for this restaurant?

Anything else you want to tell us about yourself which may help us to measure your qualifications for this position/job:(Training, prior employment)

Your Three Most Recent Jobs

Company One:

Company:

Address:

Phone:

Job Title:

Job Duties:

Reason for Leaving:

Supervisor:

Salary:

Dates Worked:

Company Two:

Company:

Address:

Phone:

Job Title:

Job Duties:

Reason for Leaving:

Supervisor:

Salary:

Dates Worked:

Company Three:

Company:

Address:

Phone:

Job Title:

Job Duties:

Reason for Leaving:

Supervisor:

Salary:

Dates Worked:

May we contact your present employer?
YesNo

I certify that the facts set forth in this employment information sheet are true and complete to the best of my knowledge. I understand that if I am employed, false statements may result in dismissal. I authorize this restaurant to make an investigation of any of the facts set forth in this employment information sheet. I understand that employment at this restaurant is “at will” which means that either I or this restaurant can terminate the employment relationship at any time with or without prior notice, and for any reason not prohibited by statue. All employment is continued on that basis. I agree to abide by all terms of employment including any alterations authorized by my employer. I understand that this employment information sheet is good for only sixty (60) days from today’s date. If I still desire a position with this restaurant after this employment application sheet expires, it will be my responsibility to fill out a new employment informational sheet and file it with this restaurant. Otherwise, this restaurant will not consider me for employment after this employment application sheet expires.