EAST WEST CUISINE APPLICATION FOR EMPLOYMENT Instructions: Print clearly in black or blue ink. Answer all questions. Sign and date the form. PERSONAL INFORMATION: Name First Middle Initial Last Social Security Number Street Address City State Zip Home Phone Cell Phone Email The best time to call you is: May we leave a message on your answering machine? Yes No Are you eligible to work in the United States? Yes No Proof of U.S. citizenship or immigration status will be required upon employment If you are under age 18, can you provide a Work Permit? Yes No Have you been convicted of a felony in the last seven years? Yes No If yes, please explain POSITION/AVAILABILITY: Position Applied For (Circle all that apply) Server Bartender Host/Hostess Line Cook Prep Cook Baker Busser Dish Washer Other ________________________________________ Days/Hours Available Sun Mon Tue Wed Thu Fri Sat From To Type of employment desired: Full-Time Part-Time Temporary Shift desired: Day Evening Night Are you willing to work overtime if required? Yes No Are you able to perform the essential functions of the job applied for with or without reasonable accommodation? Yes No If no, please explain What date are you available to start work? ________________________________________ EDUCATION: Name And Address Of School Major Degree/Diploma Graduation Date _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Skills And Qualifications: Licenses, Skills, Training, Awards _____________________________________________________________ _____________________________________________________________ EMPLOYMENT HISTORY: Present Or Last Position: Employer: _____________________________________________________ Address:______________________________________________________ Supervisor: ____________________________________________________ Phone: _______________________________ Position Title: _________________________ Dates Employed From: ______________ To: ______________ Responsibilities: ______________________________________________________________________________ ___________________________________________________________________________________________ Salary: _______________ Reason For Leaving: ____________________________________________ Previous Position: Employer: _____________________________________________________ Address:______________________________________________________ Supervisor: ____________________________________________________ Phone: _______________________________ Position Title: _________________________ Dates Employed From: ______________ To: ______________ Responsibilities: ______________________________________________________________________________ ___________________________________________________________________________________________ Salary: _______________ Reason For Leaving: ____________________________________________ Previous Position: Employer: _____________________________________________________ Address:______________________________________________________ Supervisor: ____________________________________________________ Phone: _______________________________ Position Title: _________________________ Dates Employed From: ______________ To: ______________ Responsibilities: ______________________________________________________________________________ ___________________________________________________________________________________________ Salary: _______________ Reason For Leaving: ____________________________________________ Previous Position: Employer: _____________________________________________________ Address:______________________________________________________ Supervisor: ____________________________________________________ Phone: _______________________________ Position Title: _________________________ Dates Employed From: ______________ To: ______________ Responsibilities: ______________________________________________________________________________ ___________________________________________________________________________________________ Salary: _______________ Reason For Leaving: ____________________________________________ May We Contact Your Present Employer? Yes No I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. Signature______________________________ Date__________________________________