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Employment

Contact Information

Name
Phone
Email

Contact Address

Street
City
State/Province
Zip/Postal Code

General Information

Date of Birth
November 2019
SuMoTuWeThFrSa
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
Have you ever been employed by Sun Valley Cafe before?
If yes, Name date and location employed:
Are you authorized to work in the U.S. on an unrestricted basis?
Are you eligible to receive any and all licenses/permit required by law to perform the position(s) for which you are applying?
Do you have a valid drivers license?
State:
DL#:
In the last seven years have you been convicted of or on probation for offenses involving the sale of drugs or in any manner reflecting on your honesty, integrity or propensity for violence?
If yes, please describe:
Have you ever been terminated from a job?
If yes, please explain:

Position

Applying For:
Category:
Available to begin work:
November 2019
SuMoTuWeThFrSa
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
Willing to work overtime?
Mark Days / Shifts you are available to work:

Education

Name & Address of School 1
Major/Degree 1
Date Attended 1
Graduation Date 1
November 2019
SuMoTuWeThFrSa
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
Name & Address of School 2
Major/Degree 2
Date Attended 2
Graduation Date 2
November 2019
SuMoTuWeThFrSa
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567
Name & Address of School 3
Major/Degree 3
Date Attended 3
Graduation Date 3
November 2019
SuMoTuWeThFrSa
272829303112
3456789
10111213141516
17181920212223
24252627282930
1234567

Personal References

Name 1
Address 1
Phone Number 1
Email 1
Name 2
Address 2
Phone Number 2
Email 2
Name 3
Address 3
Phone Number 3
Email 3

Employment History & Experience IMPORTANT: THIS SECTION MUST BE COMPLETED IN DETAIL.

Employer 1
Date Employed 1
Address 1
City 1
State 1
Supervisor 1
Phone 1
Reason For Leaving 1
Title & Duties 1
Employer 2
Date Employed 2
Address 2
City 2
State 2
Supervisor 2
Phone 2
Reason For Leaving 2
Title & Duties 2
Employer 3
Date Employed 3
Address 3
City 3
State 3
Supervisor 3
Phone 3
Reason For Leaving 3
Title & Duties 3

CERTIFICATION & AUTHORIZATION<br>Please read carefully before signing. I certify that the answers given herein are true and complete to my knowledge. I authorize the company and/or its agents, including consumer reporting bureaus, to investigate all statements contained in this application, as may be necessary in arriving at an employment decision (including to, but not limited to, criminal history and motor vehicle driving records). I release the company and/or its agents from any liability which might arise from such investigation. I understand that this application is not a contract of employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) will result in termination. I also understand that the use of illegal drugs or alcohol on the job is prohibited during employment. In the event that I am employed, I agree to abide by all policies and procedures of this company.

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