Application for Employment

APPLICATION FOR EMPLOYMENT

Title:
APPLICATION FOR EMPLOYMENT
(Please answer all questions)
WE ARE AN EQUAL OPPORTUNITY EMPLOYER

For Office Use Only Section:
FOR OFFICE USE ONLY
DATE STARTED
EMPLOYEE NUMBER
DEPARTMENT: Kitchen □ Bar □ Dining Room □ Other □

Notice Section:
NOTICE: Applicant should read the following information carefully before filling out any of the questions on this form. We are an equal opportunity employer and fully subscribe to the principles of equal opportunity. It is our policy to seek and employ the best qualified personnel in all positions without regard to race, color, religion, age, sex, disability, national origin or any other basis made unlawful by either state or federal law. It is our policy to comply with all federal and state employment statutes. Information requested on this application will not be used for any purpose prohibited by law.

Personal Information Section:
NAME: LAST ________________ FIRST ________________ MIDDLE ________________
PRESENT ADDRESS ________________ CITY ________________ STATE ________________ ZIP CODE ________________
( ) How long have you lived at the above address? ________________
PHONE ________________
Are you 18 years old or older? □ Yes □ No If not, state date of birth //____
If under age 18, how many hours per week are you employed elsewhere? ________________ hours
Have you had any name changes this employer should know about in order to verify job or education history? □ Yes □ No Previous Name ________________
Do you have transportation to and from work? □ Yes □ No Are you authorized to work in the U.S.? □ Yes □ No
Position applied for? ________________ Date you can start //____ Salary desired ________________
Are you applying for □ Full Time □ Part Time □ Temporary □ Days Only □ Nights Only □ Days/Nights
Who recommended you for this position? ________________

Education Section:
EDUCATION
SCHOOLING | NAME AND ADDRESS OF SCHOOL | GRADE or DEGREE COMPLETED | GRADUATE (YES/NO)

• High School
• College or University
• Others (Specify)
• Military Service Schools Attended

Military Service Record:
War Veteran □ Yes □ No | Branch ________________ | From: (Date) ________________ | To: (Date) ________________ | Highest Grade ________________

Work Experience Section:
PLEASE CHECK THE KIND OF WORK YOU HAVE DONE:
□ Bartender
□ Bookkeeper
□ Bus Person
□ Carver
□ Chef
□ Cook
□ Cook Helper
□ Counter
□ Dietitian
□ Dishwasher
□ Food Prep Technician
□ Fountain
□ Host or Hostess
□ Kitchen Helper
□ Manager
□ Pantry
□ Pastry Cook
□ Porter
□ Pot Washer
□ Salad
□ Sandwiches
□ Stenographer
□ Typist
□ Vegetable Cook
□ Wait Staff
□ Wait Staff-Arm Service
□ Wait Staff-Tray Service

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–CONTINUED ON REVERSE SIDE–

PREVIOUS RESTAURANT EXPERIENCE

Title:
PREVIOUS RESTAURANT EXPERIENCE
(LIST BELOW YOUR LAST FOUR EMPLOYERS, STARTING WITH MOST RECENT ONE FIRST)

Table Headers:
EMPLOYMENT - Last Company First | COMPANY BUSINESS | YOUR POSITION | IMMEDIATE SUPERVISOR | TITLE | EMPLOYMENT DATES | YEARLY SALARY | REASON FOR LEAVING

Section 1 (Most Recent Employer):

1. Company Name
   Address ________________
   Phone ________________
   Date Left | Salary
   Job Duties

Section 2:
2) Company Name
Address ________________
Phone ________________
Date Started | Salary
Date Left | Salary
Job Duties

Section 3:
3) Company Name
Address ________________
Phone ________________
Date Started | Salary
Date Left | Salary
Job Duties

Section 4:
4) Company Name
Address ________________
Phone ________________
Date Started | Salary
Date Left | Salary
Job Duties

Additional Questions:
Are there any job duties that you would be unable to perform? ________________
Is there anything we could do to accommodate you so you could perform all the required job duties? ________________
Have you ever applied to this company before? □ Yes □ No If yes, where? ________________ When? ________________
Are you now employed? □ Yes □ No Telephone number ________________

Emergency Contact Section:
IN CASE OF EMERGENCY NOTIFY – (NAME, ADDRESS, PHONE) RELATIONSHIP, IF ANY

Authorization Statements:

1. I authorize investigation of all statements contained in this application.
2. I understand that misrepresentation or omission of facts called for is cause for dismissal and that my employment is substantially dependent on truthful answers to the forgoing inquiries.
3. I have read these statements and answers to these inquiries. □ Yes □ No

Date ________________ Signature ________________

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WISCONSIN RESTAURANT ASSOCIATION
A service of Wisconsin Restaurant Association • Madison, WI