Server Assistant Prep Cook

EBEN'S HEARTH APPLICATION FOR EMPLOYMENT

PLEASE NEATLY PRINT THE FOLLOWING INFORMATION ON EACH LINE

(RESUMES ARE WELCOME, BUT THIS APPLICATION MUST BE FILLED IN ITS ENTIRETY) TODAY'S DATE / /

NAME (L) (F) (MI) PHONE INFO HOME WORK CELL DATE OF BIRTH / / SOCIAL SECURITY NUMBER __ __ __-__ __-__ __ __ __ PRESENT ADDRESS CITY ST PERMANENT ADDRESS CITY ST POSITION SEEKING: KITCHEN--(_)LINE COOK (_)PREP COOK (_)BUSER/ DISHWASHER FRONT OF THE HOUSE--(_)WAITSTAFF, (_)SERVER ASSISTANT, (_)HOST/ HOSTESS DO YOU OWN A CAR? (_)YES / (_)NO

IF YES, IS IT IN YOUR POSSESSION FOR USE NOW? (_)YES / (_)NO NUMBER OF HOURS DESIRED (_)10 OR LESS, (_)10 – 20, (_) 20-30, (_) FULL TIME (35 – 40) MOST RECENT EMPLOYER FROM / TO / NAME OF SUPERVISOR PHONE # EMPLOYER ADDRESS CITY ST YOUR POSITION WITH COMPANY WAGE REASON FOR LEAVING 2ND MOST RECENT EMPLOYER FROM / TO / NAME OF SUPERVISOR PHONE # EMPLOYER ADDRESS CITY ST YOUR POSITION WITH COMPANY WAGE REASON FOR LEAVING 3RD MOST RECENT EMPLOYER FROM / TO / NAME OF SUPERVISOR PHONE # EMPLOYER ADDRESS CITY ST YOUR POSITION WITH COMPANY WAGE REASON FOR LEAVING EDUCATION

HIGH SCHOOL CITY STATE YR OF GRADUATION COLLEGE CITY STATE YR OF GRADUATION CONTINUING EDUCATION: SCHOOL MAJOR GPA HOW LONG DO YOU EXPECT TO REMAIN IN THE POTSDAM AREA? BUSINESS REFERENCES (OTHER THAN LISTED ABOVE), NON-RELATIVES NAME YRS. ACQUAINTED PHONE # YOUR ASSOCIATION WITH THIS PERSON NAME YRS. ACQUAINTED PHONE # YOUR ASSOCIATION WITH THIS PERSON NAME YRS. ACQUAINTED PHONE # YOUR ASSOCIATION WITH THIS PERSON WHAT ARE YOUR UNIQUE QUALITIES THAT MAKE YOU A BETTER SUITED CANDIDATE FOR THIS POSITION THAN OTHER APPLICANTS?

CIRCLE THE HOURS YOU ARE UNAVAILABLE TO WORK? (The more your availability is limited, the less likely you are to get an interview.) TUESDAY AM 8 9 10 11 NOON 1 2 3 4 5 6 7 8 9 10 11 PM WEDNESDAY AM 8 9 10 11 NOON 1 2 3 4 5 6 7 8 9 10 11 PM THURSDAY AM 8 9 10 11 NOON 1 2 3 4 5 6 7 8 9 10 11 PM FRIDAY AM 8 9 10 11 NOON 1 2 3 4 5 6 7 8 9 10 11 PM SATURDAY AM 8 9 10 11 NOON 1 2 3 4 5 6 7 8 9 10 11 PM SUNDAY AM 8 9 10 11 NOON 1 2 3 4 5 6 7 8 9 10 11 PM I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. I also understand that any change to the information on this application will bring my continued employment under review. SIGNATURE DATE / / APPLICATION ACCEPTED BY: