Employment Application

EMPLOYMENT APPLICATION
Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone*

Area CodePhone Number
E-mail*
Position applied for*
Referred by *
Desired Wage*
Type of employment looking for*

Full TimePart TimeSeasonalOn-Call

Days Available*

	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Times Available (e.g. 9AM-5PM)

What is the best job you ever had? What did you like about it?
Describe what hospitality means to you. Give an example of a good and bad service experience.
Describe a time when you were complimented for going above and beyond expectations?
What is your reaction to the famous sentence "That is not my job."
What are the most encouraging words anyone has ever said to you?
Are you authorized to work in the United States? *

YesNo
Will you require sponsorship by Los Poblanos to maintain your work authorization now or in the future?*

YesNo
Have you ever worked for Los Poblanos?*

YesNo
When were you employed at Los Poblanos?

Education

	School Name	City, State	Years	Degree Earned
School 1
School 2
School 3
School 4

Employment History
Upload a Resume

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Company Name
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Job Title
Responsibilities
Dates of Employment
Reason for Leaving
Company Name
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Job Title
Responsibilities
Dates of Employment
Reason for Leaving
Company Name
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Job Title
Responsibilities
Dates of Employment
Reason for Leaving
References
Name

First NameLast Name
Relationship
Company
Title
Years Known
Phone Number

Area CodePhone Number
Name

First NameLast Name
Relationship
Company
Title
Years Known
Phone Number

Area CodePhone Number
Name

First NameLast Name
Relationship
Company
Title
Years Known
Phone Number

Area CodePhone Number
Please list any additional qualifications or experience
Please read and initial each paragraph, then sign below:
Initial with mouse*

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I certify that I hove not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me ore true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I om employed by this company, terms for my immediate expulsion from the company.
Initial with mouse*

Clear
I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.
Initial with mouse*

Clear
I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & oil other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
E-Signature*

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Use your mouse to sign
Date*

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EMPLOYMENT APPLICATION

Applicant Information

Employment History

References