Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you at least 18 years of age? *

Yes

No

Are you a citizen of the United States or otherwise legally eligible for employment in the U.S.? *

Yes

No

Positions *

Server

Cook

Prep Cook

Dishwasher

Any Available

To the best of your knowledge, are you able to perform the functions of the job(s) for which you are applying? *

Yes

No

Date you can start. *

MM

DD

YYYY

Do you have any scheduling conflicts? *

Yes

No

Education *

Some High School

High School Graduate

Some College

College Graduate

Are you currently employed? *

Yes

No

May we contact your current employer? *

Yes

No

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

Leave blank if currently employed

MM

DD

YYYY

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Reference #1 *

First Name

Last Name

Phone *

(###)

###

####

Reference #2 *

First Name

Last Name

Phone *

(###)

###

####

Reference #3 *

First Name

Last Name

Phone *

(###)

###

####

Have you ever been convicted of a crime or currently subject to any pending arrests? A criminal record will not automatically bar employment, but will be considered only as it reasonably relates to the positon for which you are applying. *

Yes

No

I certify that the information contained in this application are true and correct to the best of my knowledge and understand that any misstatement or omission of information will constitute grounds for my immediate dismissal or rejection of my application. The correctness of all statements made in this application may be investigated. In connection with such investigation, I authorize all former employers and other persons contacted to release any and all information in their possession which has or may have a bearing on my suitability as an applicant, and I release all employers or other persons supplying or requesting such information from any and all liability. *

By checking the box, I declare that I have carefully read and understand the statement and do so consent.

Date *

MM

DD

YYYY

I recognize and acknowledge that Sapore Grill is fully committed to a work place free from illegal drugs and the use of illegal drugs. In this regard I expressly consent, if required, to a pre-employment drug test, the results of which will be considered by Sapore Grill in its decision to hire me. *

By checking the box, I declare that I have carefully read and understand the statement and do so consent.

Date *

MM

DD

YYYY