Restaurant Application Form

Cleangoodeats Application for Employment

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability, or other protected classifications.Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application. A résumé will be required for this position. Please email your questions to jacquelineb@cleangoodeats.com.
Full Name*

First NameMiddle InitialLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
Available start date:*

MonthDayYear
Are you authorized to work and remain in the United States?

YesNo
Position Apply For

Availability, Check the shifts you are available

	AM	PM
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Have you been told the essential functions of the job, or have you viewed a copy of the job description listing the essential functions of the job?

YesNo
Can you perform these essential functions of the job with or without reasonable accommodation?

YesNoNot Sure
SPECIAL SKILLS: List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.
Education:
Are you a High School Graduate?

YesNo
High School Equivalency?

YesNo
Are you presently attending school?

YesNo
Type of Education
Employment History

Beginning with your present or most recent experience, account for all employment during the past ten (10) years. To elaborate, a supplemental sheet or resume may be attached, but cannot be substituted for a completed application. Include military service if applicable.
Name of Employer:
Job Title:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Supervisor:
Date started

MonthDayYear
Date ended

MonthDayYear
Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

YesNo
Name of Employer:
Job Title:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Supervisor:
Date started

MonthDayYear
Date ended

MonthDayYear
Reason for Leaving:
Description of Duties:
Inquiry may be made of your current and former employers/schools you attended.
May we contact your present employer?

YesNo
May we contact your former employers?

YesNo
Professional References
Reference #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business or Occupation*
Phone Number*

Area CodePhone Number
Reference #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business or Occupation*
Phone Number*

Area CodePhone Number
Upload Resume*

Upload a File

Cancelof
I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed,
false statements, omissions, or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth
in this application and release the Employer from any liability. The employer may contact any listed references on this application.
I acknowledge and understand that the company is an “at-will” employer. Therefore, any employee (regular, temporary, or another type of category employee)
may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or
without notice to the other party.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Cleangoodeats Application for Employment

Education:

Employment History

Professional References