RJ's Eatery - Employment

Contact Information
*Name: Last First Middle
Other name under which employed:

*Address:
*City:	State: Zip:
*Home Phone:
Message Phone:
Email Address:

*Are you 16 years of age or older? Yes     No

Social Security Number (Subject to Verification):
*Do you have a legal right to work in the U.S.? Yes     No

Placement Information
*Position For Which You Are Applying Other - Please specify:
Wage Rate Required: $ Per Hour
Total Hours Needed per Week:

If you are applying for a server/bartender job, you must be old enough to serve or handle liqour.
Can you establish that age if offered a job? Yes     No

List skills you have related to the job you are seeking:

Hours Available:

.	Mon	Tues	Wed	Thur	Fri	Sat	Sun
From
To

*Do you have reliable transportation? Yes     No
*When could you start work?
*Are you able to perform the essential functions of the job you are seeking? Yes     No

General Information
*Have you ever applied here? Yes     No
If yes, when:

*Have you ever been fired? Yes     No
If so, explain:

*Have you ever been convicted of a crime, received deferred adjudication, pled no contest, or been placed on probation for a crime (other than minor traffic violations)? Yes     No
If yes, explain in detail: *(a yes answer is not an automatic disqualification)

If you are applying for a back of the house position, can you, with or without accomodation: lift and carry sacks and cases up to 70 lbs up to 20 times per shift; frequently bend, stoop, reach; stand for 6-8 hrs; and, hear co-workers' or managers' requests above loud background noise? Yes     No

If you are applying for a front of the house position, can you, with or without accomodation: lift up to 30 lbs; reach, bend stoop; stand/walk for 6-8 hours; and, hear guests' requests above loud background noise? Yes     No

Education/Qualifications Please list any education, qualifications, training, or specialized experience you feel relates to the job you have applied for and which would help you perform the work. list schools, diplomas, degrees, vocational training, licenses, military training, etc.

School	Location	Diploma, Degree, Licenses, Training, etc.

Employment History(Begin with most recent or present employer, include military, self employment, etc.)
May we contact your present employer? Yes No

Company Name:
Address:
Supervisor's Name:
Job title (describe your work):

Telephone:
Employed From: (MM/YY)	To:
Weekly Pay:
Reason for Leaving:

Company Name:
Address:
Supervisor's Name:
Job title (describe your work):

Telephone:
Employed From: (MM/YY)	To:
Weekly Pay:
Reason for Leaving:

Company Name:
Address:
Supervisor's Name:
Job title (describe your work):

Telephone:
Employed From: (MM/YY)	To:
Weekly Pay:
Reason for Leaving:

(Please read before verifying)
I certify that the information provided in this application by me is correct. I understand that all information provided on this application is subject to verification. I understand that any offer of employment is conditioned upon this verification of information and any offer of employment is further conditioned upon furnishing satisfactory evidence of identity and legal authority to work in the united states. If hired, I understand that if it is found that I falsified any information on this application, on any resume or during any interview, it may result in my immediate termination of employment. I understand that nothing contained in this employment application or in the granting of an interview creates an employment contract between RJ's Eatery and myself for employment. If an employment relationship is established, I understand that I have the right to terminate my employment at any time, and that RJ�s Eatery retains the same right.

This communication in no way constitutes a contract or agreement for employment. Accordingly, neither the uniform electronic transaction act, the electronic signatures in global and national commerce act, nor any other similar laws apply to this communication.

*Name Verification (first and last name)
*Date Verification (mm/dd/yyyy)

RJ�s eatery is an equal opportunity employer and complies with all discrimination laws. All qualified applicants receive consideration for employment without regard to sex, religion, race, color, national origin, age, disability or other classification protected by law. All offers are conditioned upon furnishing satisfactory evidence of identity and legal authority to work in the united states. Information on this application will not be used for any purpose prohibited by law.