Employment Application

LOCATION WHERE YOU ARE APPLYING TO WORK*
ADDITIONAL LOCATION(S) WHERE YOU CAN WORK

List other cities or restaurant location(s) where you would like to work
DO YOU HAVE A DRIVER'S LICENSE?*
- Yes
- No
IF YES, WHAT STATE*
DO YOU HAVE A SOCIAL SECURITY NUMBER?*
- Yes
- No
NAME*
First Middle Last
Phone*
Email*
Mailing Address*
Street Address City
State ZIP Code
ARE YOU LESS THAN 18 YEARS OF AGE?
- Yes
- No
REGULATIONS PROHIBIT USE OF SOME EQUIPMENT BY THOSE UNDER 18.
ARE YOU ELIGIBLE FOR EMPLOYMENT IN THE U.S.?
- Yes
- No
NOTE: PROOF OF U.S. CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED IF HIRED.

SEEKING A POSITION THAT IS*
SEEKING WORK HOURS THAT ARE*
DATE YOU CAN START*
MM slash DD slash YYYY
WAGE EXPECTED
HOURS AVAILABLE WEEKLY*

This could be left as "Full time" or you may type in a number of hours between 5 and 40.
HOURS AVAILABLE DAILY

This could be left as is or you may type in certain days or times as "unavailable."

NAME & LOCATION OF SCHOOL, COLLEGE OR UNIVERSITY*
COURSE OF STUDY OR MAJOR*
HOW LONG DID YOU ATTEND?*
DID YOU GRADUATE?*
- Yes
- No
DEGREE OR CERTIFICATE RECEIVED*

Specialized Skills and Knowledge
Please list any other employment, voluntary work, or personal projects that you think may be related to the job for which you are applying.

Please provide the names of three references other than friends or family whom you have known for at least one year.
Reference 1
NAME*
CITY AND STATE*
PHONE*
YEARS KNOWN*
Reference 2
NAME
CITY AND STATE
PHONE
YEARS KNOWN
Reference 3
NAME
CITY AND STATE
PHONE
YEARS KNOWN

NAME OF BUSINESS, CITY, STATE
TYPE OF BUSINESS / YOUR JOB TITLE
DUTIES PERFORMED AT THIS JOB
SUPERVISOR'S NAME AND PHONE NUMBER
MAY WE CONTACT HIM/HER?
- Yes
- No
START AND END DATES

Month And Year for each Start and End dates
TOTAL TIME IN POSITION
AVERAGE HOURS WORKED PER WEEK
SUPERVISION / LEAD WORK (CHECK AREAS OF RESPONSIBILITY)
- HIRE OTHERS
- RECOMMEND HIRING
- ASSIGN AND REVIEW WORK
- HANDLE DISCIPLINARY OPTIONS
- RATE WORK PERFORMANCE
- RESPOND TO GRIEVANCE
REASON FOR LEAVING

NAME OF BUSINESS, CITY, STATE
TYPE OF BUSINESS / YOUR JOB TITLE
DUTIES PERFORMED AT THIS JOB
SUPERVISOR'S NAME AND PHONE NUMBER
MAY WE CONTACT HIM/HER?
- Yes
- No
START AND END DATES

Month And Year for each Start and End dates
TOTAL TIME IN POSITION
AVERAGE HOURS WORKED PER WEEK
SUPERVISION / LEAD WORK (CHECK AREAS OF RESPONSIBILITY)
- HIRE OTHERS
- RECOMMEND HIRING
- ASSIGN AND REVIEW WORK
- HANDLE DISCIPLINARY OPTIONS
- RATE WORK PERFORMANCE
- RESPOND TO GRIEVANCE
REASON FOR LEAVING

BEFORE SUBMITTING THIS WEB FORM, PLEASE REVIEW THIS APPLICATION TO MAKE SURE YOU HAVE ANSWERED ALL QUESTIONS.
- I understand that any statement, verbal or written, made by me or by others at my request, contained in this application or attached hereto, or in the course of any related employment process, that is false, fraudulent or misleading, will result in rejection of my application, denial of employment, or if hired, dismissal from employment if discovered after employment.
- I understand that, if hired, I may be required to sign a confidentiality and/or non-compete agreement.
- I understand that nothing contained in this application, or conveyed during any interview that may be granted, is intended to create an employment contract.
- I certify that all statements contained herein are true and complete whether made by me or others at my request.
- I understand that if hired, I must prove that I am legally authorized to work in the United States.
- I understand that filling out this form does not indicate there is a position open and does not obligate employer to hire me.
- I authorize employer to investigate my background, references, employment record, education information, and other matters related to my suitability for employment.
- I understand that I will be required to provide my driving record if the position for which I am applying requires driving.
- I authorize persons, schools, my current employer (if applicable), and previous employers and organizations contacted by employer to provide any relevant information regarding my current and/or previous employment and I release all persons, schools, and previous employers of any and all claims for providing such information.
- I understand that I may be asked to submit to a pre-employment drug test, a credit history check, and/or a criminal history background check as a condition of employment.
- I understand and agree that, if hired, my employment is at-will, which means that it is for no specified period and may be terminated by me or employer at any time without prior notice for any reason.
- I release employer and all providers of information from any liability as a result of furnishing and receiving any information related to the hiring process.
Consent*
I ACCEPT THE ABOVE TERMS
IF YOU DO NOT ACCEPT THE ABOVE TERMS, YOUR INTEREST FORM WILL NOT BE FULLY PROCESSED.
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Café Yumm!

Step 1 of 9 - Personal Information

Reference 1

Reference 2

Reference 3