APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT
Burrito Bistro is an equal opportunity employer. All applicants are considered without regard to race, age, color, gender, ethnic group, national origin, religion, citizenship, marital status, sexual orientation, veteran status, physical or mental disability, or medical condition, or any other basis prohibited by federal, state or provincial law.
Today’s Date (mm/dd/yr)

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PERSONAL INFORMATION
Last Name
First Name
Middle Initial
SS # (optional)
Date of Birth (mm/dd/yr)

MonthDayYear
Date
Address
City
State
Zip Code
Phone Number
Email
example@example.com
Which location are you seeking employment

DennisHyannisMashpeeAny Location
Position Applied for

ManagerCookCounterPrep / DishwasherAnyOtherOther
Minimum number of hours you would like to work per week
Maximum number of hours you would like to work per week
Desired Hourly Pay
Available Start Date (mm/dd/yy)

MonthDayYear
Date
I want to work

Full-timePart-timeLong-term (year-round)Short-term (seasonal)Day ShiftsNight Shifts

When can you work

	Anytime	Start Time	Finish Time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

EDUCATION

	Name, City, State	Current Level Date Graduated	Studied/Degree License/Certificate
High School
College
Vocational, Military, Other

COMMUNICATION SKILLS

EnglishSpanishPortugueseFrenchGermanRussianOther
How did you find-out about this position?

Walk-InInternetFriendEmployee Referral
Name of Referring Employee
Have any of your relatives or friends been employed by Burrito Bistro

YesNo
If YES, please provide their name(s)
Will you be able to perform the job functions for the position you are applying for

YesNo
Have you ever been convicted of a crime

YesNo
If YES, explain:
REFERENCES
Please provide two personal references we can contact. (not relatives or previous employers)
1. Reference Name
1. Reference City, State
1. Reference Phone
1. Reference Relationship
2. Reference Name
2. Reference City, State
2. Reference Phone
2. Reference Relationship
EMPLOYMENT HISTORY Please list employment record, starting with the most recent.
1. Business Name, City, State
1. Job Title / Duties
1. Start Date

MonthDayYear
Date
1. End Date

MonthDayYear
Date
1. Supervisor Name and Job Title
1. Supervisor Phone Number
1. Reason for Leaving
2. Business Name, City, State
2. Start Date

MonthDayYear
Date
2. End Date

MonthDayYear
Date
2. Job Title / Duties
2. Supervisor Name and Job Title
2. Supervisor Phone Number
2. Reason for Leaving
3. Business Name, City, State
3. Job Title / Duties
3. Start Date

MonthDayYear
Date
3. End Date

MonthDayYear
Date
3. Supervisor Name and Job Title
3. Reason for Leaving
May we contact your present employer(s)

YesNo
APPLICANT STATEMENT

I understand and agree to the following:

This application is not a contract of employment.

Should Burrito Bistro hire me and should any of the information I have given in this application be found false, misleading, or incomplete, I shall be subject to dismissal.

Burrito Bistro follows an “at will” employment policy, meaning I or Burrito Bistro may terminate employment at any time for any reason consistent with applicable law.

All hired persons must provide proof of identity and authorization to work in the US. Failure to produce such proof will result in denial of employment.

I authorize investigation of all statements given on this application. Burrito Bistro may contact any educational institution, reference, or employer listed on this application, except my current employer if so noted, to verify the information I have given. I hereby release all involved parties from any liability arising from such an investigation.

I certify that all the information given in this application is complete and true.
Signature of Applicant *

Clear
Date (mm/dd/yy)

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Should be Empty:

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION