Last Name*:
First Name*:
Middle Name:
Local Address:
Local City, State, Zip:
Local Phone:
Permanent Address:
Permanent City, State, Zip:
Permanent Phone:
Emergency Contact:
Emergency Address:
Emergency Phone:
If hired, can you provide documentation of your identity and eligibility for employment in the United States? (NOTE: To comply with the Immigration Reform and Control Act, we require all employees to show proof of their eligibility to work in the U.S.)
Yes
N o
Email Address:
I am available for work beginning:
I am available for weekends prior to this date:
Yes
No
I will not be available for work after:
I will available for weekends after this date:
Yes
No
I am available for the following schedule:
Position desired and expected compensation:
Do you have reliable transportation:
Yes
No
Have you ever worked at a full service or buffet restaurant?
Yes
No
Have you ever been employed by the Embers?
Yes
No
If yes, date(s), position and reason for leaving:
High School
Name and Location:
Years completed:
Did you graduate?
Yes
No
Degree or diploma received/course of study:
College
Name and Location:
Years completed:
Did you graduate?
Yes
No
Degree or diploma received/course of study:
Graduate School
Name and Location:
Years completed:
Did you graduate?
Yes
No
Degree or diploma received/course of study:
Other
Name and Location:
Years completed:
Did you graduate?
Yes
No
Degree or diploma received/course of study:
During the last ten years (or since you were 18 years of age, whichever period is shorter), have you been convicted of a misdemeanor (other than minor traffic violation) or a felony or convicted in a military court-martial? (NOTE: You may omit convictions that have been expunged. A conviction will not necessarily disqualify any applicant.)
Yes
No
If yes, state the crime and the date of conviction:
Please give an accurate and complete listing of all full-time and part-time employment. Start with present or most recent employment.
Company Name:
Company Address:
Company City, State, Zip:
Company Phone:
Name of Manager:
Job title or description of your work:
Employed: (Month and Year)
From:
to:
Ending Compensation:
Reason for leaving:
Company Name:
Company Address:
Company City, State, Zip:
Company Phone:
Name of Manager:
Job title or description of your work:
Employed: (Month and Year)
From:
to:
Ending Compensation:
Reason for leaving:
List any other job related experiences, special training, skills, apprenticeships, internships, etc.:
(Read carefully prior to submitting)