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Date Month
Day
Year
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| FirstName |
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Last Name |
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Middle Name |
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| Address
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| City
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| State |
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| Zip
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| Telephone |
(
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Email
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| Confirm
Email |
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If
you are under 18 years of age, can you provide required proof of
your eligibility to work?
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Are
you prevented from lawfully becoming employed in this country
because of your Visa or Immigration Status? Proof of citizenship
or immigration status will be required upon employment.
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Do
you have a valid Drivers License? If
yes, please provide State and Number:
State
Number
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Date
available to work? |
Month
Day Year
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Are
you able to work:
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EveningsWeekends
Holidays
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Have
you ever been convicted of a felony? |
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| Have
you been convicted of a misdemeanor within the last five years? |
If
yes to one or both of the above questions, you must explain
below even if you received a suspended imposition of a sentence.
Conviction will not necessarily disqualify an applicant from
employment.
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| Employment
History |
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May
we contact your present employer? |
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Most
Recent Employer |
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|
Address
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Telephone |
( )
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Date
Started |
Month Day Year |
|
Starting
Salary |
$
per |
|
Starting
Position
|
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Date
Left |
Month Day Year |
|
Salary
upon Leaving |
$
per |
|
Position
upon Leaving |
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|
Name
of Supervisor |
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|
Title
of Supervisor |
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|
Reason
for Leaving |
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|
Description
of Duties |
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Employer
|
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|
Address
|
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|
Telephone |
( )
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|
Date
Started |
Month
Day Year |
| Starting
Salary |
$
per |
| Starting
Position
|
|
| Date
Left |
Month Day Year |
| Salary
upon Leaving |
$
per |
| Position
upon Leaving |
|
| Name
of Supervisor |
|
| Title
of Supervisor |
|
| Reason
for Leaving:
|
|
|
Description
of Duties
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|
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|
Employer
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|
| Address
|
|
| Telephone |
( )
|
| Date
Started |
Month
Day Year |
| Starting
Salary |
$
per |
| Starting
Position |
|
| Date
Left |
Month
Day Year |
| Salary
upon Leaving
|
$
per |
| Position
upon Leaving
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| Name
of Supervisor
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| Title
of Supervisor |
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| Reason
for Leaving
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| Description
of Duties |
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| Education |
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| High
School |
Diploma
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| Undergraduate
College |
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| Course
of Study |
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| Years
Completed
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Degree
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| Graduate
College |
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|
Course
of Study |
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| Years
Completed
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Degree
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Other
(Specify) |
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Describe
any specialized training, apprenticeship, skills and extra-curricular activities
|
Additional
Information: (State any additional
information you feel may be helpful to us in considering your application.
Summarize special job-related skills and qualifications from employment or other
experience.
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Note
to Applicants:
DO
NOT ANSWER THE FOLLOWING QUESTION UNLESS YOU HAVE REVIEWED THE REQUIREMENTS OF
THE JOB FOR WHICH YOU ARE APPLYING, PLEASE SEE JOB DESCRIPTION.
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Are
you capable of performing in a reasonable manner, with or without reasonable
accommodations, the activities involved in the job or occupation for which you
have applied?
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References:
Do not include family members or past supervisors.
|
| Name
|
|
| Telephone |
( )
|
| Occupation |
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|
| Name
|
|
| Telephone
|
(
)
|
| Occupation |
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|
| Name
|
|
| Telephone
|
(
)
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| Occupation |
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| Applicant’s
Statement
I
certify that answers given herein are true and complete to the best of my
knowledge and that I have not knowingly withheld any fact or circumstance. I
understand that falsifying or omitting information on this form may cause me to
be disqualified from further consideration or dismissed from employment if
hired.
This
application for employment shall be considered active for a period of 45 days.
Any applicant wishing to be considered for employment beyond this time period
should inquire as to whether or not applications are being accepted at that
time.
All
employment offers are made contingent upon satisfactory proof of legal
authorization to work in the United States according to the law. I understand
that failure to provide satisfactory proof of identity and authorization to work
in the United States will disqualify me from employment.
This
application does not constitute an agreement or contract for employment for any
specified period or definite duration. I understand that no representative of
the employer is authorized to make assurances to the contrary and that no
implied, oral or written agreements contrary to the foregoing express language
are valid unless they are in writing and signed by Melting Pot Catering.
I
understand that if hired, I may be required to undergo a physical examination,
have a photograph taken, and drug and alcohol test if my job requires driving,
or if I should become involved in an accident while on duty, on company
premises, on job sites, or in a company vehicle, or if a reasonable suspicion of
drug or alcohol use exists based on my performance, appearance, an/or behavior.
The examination and the test will be performed at the employer’s expense, by
the employer’s representative.
I
expressly authorize, without reservation, the employer, its representatives,
employees or agents to contact and obtain information from all references
(personal and professional), employers, public agencies, licensing authorities,
and educational institutions and to otherwise verify the accuracy of all
information provided by me in this application, resume, or job interview. I
hereby waive any and all rights and claims I may have regarding the employer,
its agents, employee or representatives, for seeking, gathering and using such
information in the employment process and all other persons, corporations or
organization for furnishing information about me.
I
acknowledge that I have read this authorization and release, fully understand
it, and fully and voluntarily agree to its provisions.
By
typing your name and dating in the boxes below you are acknowledging the
authorization and release and fully and voluntarily agree to the provisions of
this application.
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Signature of Applicant |
Month
Day Year
Date |
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