Employment Application

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Name (First, Middle, Last)

Desired Wage

Referral Source(required)

Internet

Relative

Employee

Other

Permanent Address

City, State, Zip

Phone (ex. 555-555-5555)

Local Address

City, State, Zip

Are you under the age of 18?(required)

Yes

If you answered YES to the above question, can you furnish a work permit?

Yes

If hired, when would be your starting date? (YYYY-MM-DD)

If hired, when would be your ending date? (YYYY-MM-DD)

Are you available for training, weekends in April and May?

Yes

Are you available to work Labor Day Weekend?

Yes

Are you eligible to work in the US?(required)

Yes

Do you participate in any activities or sports that would require you to need time off?(required)

Yes

If you answered YES to the above question, name the activity or sport and when they occur:

Do you or your family routinely take vacations during the summer months?(required)

Yes

If you answered YES to the above question, when will they occur:

Are there any prior commitments you have that we need to know about that could cause scheduling difficulties?(required)

Yes

If you answered YES to the above question, when will they occur:

EDUCATION

Name of School

Years Completed

When do classes end?

When do classes begin?

Will you need time off prior to starting school?(required)

Yes

If you answered YES to the above question, how much time will you need:

EMPLOYMENT – List below your most recent employment beginning with the most current.

Place of Employment #1

Job Title/Position

Contact Person and Phone (ex. 555-555-5555)

Reason of Leaving

Place of Employment #2

Job Title/Position

Contact Person and Phone (ex. 555-555-5555)

Reason for Leaving

Del’s Oceanside Grill is a drug-free work environment and holds the right to random drug testing if necessary.

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed; falsified statements shall be grounds for dismissal. I authorize investigation of the statements contained herein and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, “If hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause.”

ENTER TODAY’S DATE (YYYY-MM-DD)

ELECTRONIC SIGNATURE (FIRST AND LAST NAME – THIS IS A LAWFUL SIGNATURE)