Employment Application

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*

Rows	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

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

Upload a Resume

Upload a File

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

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*

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*

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*

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*

Use your mouse to sign

Date*

MonthDayYear

EMPLOYMENT APPLICATION

Applicant Information

Employment History

References