Employment Application

Habaneros Employment Application

Name(Required)

First Last

Current Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Permanent Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Personal Phone(Required)

Other Phone

Email(Required)

Have You Ever Worked Under A Different Name?(Required)

Yes

I Can Work(Required)

Full Time

Part Time

Temporary

Permanent

Times I Can Work(Required)

Employment Record

Record last position first. Failure to accurately account for all periods during the last seven years may lead to your application not being considered. If omissions or falsifications are discovered subsequent to your employment, such omissions or falsifications will be sufficient cause for discharge. (List periods of school as follows: School name under company name and dates attended.)

Company Name / Address

Start Date

Leave Date

Supervisor

Phone

Job Titles & Duties

Reason For Leaving

Wage Start

Wage End

Were You Unemployed Between Positions?

Yes

Add Position

Company Name / Address

Start Date

Leave Date

Supervisor

Phone

Job Titles & Duties

Reason For Leaving

Wage Start

Wage End

Were You Unemployed Between Positions?

Yes

Add Position 2

Add Position

Company Name / Address

Start Date

Leave Date

Supervisor

Phone

Job Titles & Duties

Reason For Leaving

Wage Start

Wage End

Were You Unemployed Between Positions?

Yes

Educational Record

Number Of Years Completed(Required)

High School

High School Degree Received

High School Course Work

Trade School(s)

Trade School Degree Received

Trade School Course Work

College(s)

College Degree Received

College Course Work

General Information

Are You Older Than 18?(Required)

Yes

Have You Ever Asked To Resign Or Been Fired For Cause?

Yes

Have You Ever Applied To This Company Before?(Required)

Yes

Have You Worked For This Company Before?(Required)

Yes

Do You Have Reliable Means To Get To And From Work?(Required)

Yes

May We Contact Your Previous Employers?

Yes

If An Alien, Do You Have The Right To Accept Employment In The U.S.?(Required)

Yes

(Upon employment, verification of legal employment status will be required.)

Are You Now Or Have You Ever Been In The Military?

Yes

List The Names Of Any Relative Working For Habaneros And Their Relationship To You

List Additional Names Of People Working Here Who You Know Well:

References

Reference 1 - Name/Title

Reference 1 Phone

Reference 1 Years Known

Reference 2 - Name/Title

Reference 2 Phone

Reference 2 Years Known

Reference 3 - Name/Title

Reference 3 Phone

Reference 3 Years Known

Important - Please Read Carefully

I hereby authorize investigation of all statements contained in this application, including inquiry of any and all of my former employers or references as indicated elsewhere in the application, and hold said former employers and/or references harmless from liability arising therefrom. I affirm that all the information contained in this application is true and correct, and that any misrepresentation, falsification or omission herein shall be sufficient reason for dismissal from, or refusal for employment. If employed, I understand that the company reserves the right to modify or terminate my employment at any time, with or without cause, and without prior notice. I further understand that the duration, hours, nature, compensation and benefits of my employment may be changed or modified from time to time without limitation or condition. I understand that no representative of the company has any authority to make any assertions to the contrary. I hereby agree to abide by all policies and rules of this company which govern dress, hair, grooming and attitude.

CAPTCHA