Friends American Grill - Restaurant & Bar

APPLICATION PRE-EMPLOYMENT QUESTIONNAIRE / EQUAL OPPORTUNITY EMPLOYER PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE The Restaurant is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, gender, sexual orientation, national origin, citizenship, age, disability or any other protected classification. We assure you that your opportunity for employment with the Restaurant depends solely on your qualifications.

PERSONAL INFORMATION

Name *

Last

Email *

Phone Number *

Address *

City

State/Province

Zip/Postal

Country

DESIRED EMPLOYMENT

FORMER EMPLOYMENT

Previous Employer 1

Name & Address

From / To

Salary

Position

Reason for Leaving

Previous Employer 2

Name & Address

From / To

Salary

Position

Reason for Leaving

Previous Employer 3

Name & Address

From / To

Salary

Position

Reason for Leaving

REFERENCES (the name of three persons not related to you, whom you have known for at least one year)

Reference 1

Name

Relationship

Phone Number

Years Known

Business

Reference 2

Name

Relationship

Phone Number

Years Known

Business

Reference 3

Name

Relationship

Phone Number

Years Known

Business

EDUCATION, SKILLS AND ADDENDUMS

Name and Location of Last School Attended

Years Attended

Graduation Year

Subjects of Special Study / Research Work or Special Training / Skills

United States Military or Naval Service

Rank

AUTHORIZATION *

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from untilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

Signature *

Date *