Employment | Innovative Dining Group

Name of Location or Concept

Last*

First*

Middle Initial

Street Address

Apt.

City

State

Zip

Email Address*

Position(s) Desired

Hours Available to Work

Full Time

Part Time

If hired, can you submit proof of legal right to work in the US?

YesNo

Telephone: Please indicate*

HomeOfficeMobile

()

Telephone: Please indicate

HomeOfficeMobile

()

PREVIOUS EMPLOYMENT HISTORY

LIST YOUR POSITIONS OF THE PAST TEN YEARS; LIST MOST RECENT EMPLOYER FIRST.

(1) EMPLOYER (most recent)

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

May We Contact?

yesno

(2) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(3) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(4) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(5) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(6) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(7) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(8) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(9) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(10) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

(11) EMPLOYER

Address

City

State

Zip

Dates Employed

Year:Month:

Supervisor

Positions Held

Telephone

Duties

Rate of Pay

Reason for Leaving

ADD EMPLOYER

HAVE YOU READ AND SIGNED A JOB DESCRIPTION FOR THE POSITION YOU ARE APPLYING FOR EMPLOYMENT?

YESNO

CAN YOU PERFORM THE ESSENTIAL FUNCTIONS OF THE POSITION FOR WHICH YOU ARE APPLYING?

YESNO

DO YOU HAVE ANY RELATIVES EMPLOYED WITH OUR COMPANY?

YESNO

IF YES, LIST NAMES AND POSITIONS

HAVE YOU EVER BEEN CONVICTED OF A CRIME?

YESNO

IF YES, PLEASE LIST THE DATE, PLACE, CHARGE, & DESPOSITION:

You need not disclose a conviction a) that was judicially expunged or sealed b) for a marijuana-related offense over 2 years old; c) if you completed a pre- or post- trial diversion program; or, d) for a misdemeanor for which probation was successfully completed (or discharged) and the case was judicially dismissed. A conviction will not necessarily be a bar to employment.

EDUCATION

HIGHEST GRADE COMPLETED:

COLLEGE

DEGREE(s) / LICENSE(s) HELD

NAME OF LAST SCHOOL ATTENDED

OTHER TRAINING OR TRADE SCHOOL

WHICH COMPUTER PROGRAMS CAN YOU OPERATE?

WHICH LANGUAGE(S) OTHER THAN ENGLISH DO YOU SPEAK FLUENTLY?

OTHER KNOWLEDGE, SKILLS, OR ABILITIES

PERSONAL REFERENCES

List the name, telephone number, and relationship of two individuals who will act as personal references. Do not list family members.

1.

2.

REFERRAL SOURCE

How did you hear about the position you are applying for:

Internet

Newspaper

Friend

Other

If you were referred by an employee, please print their name here:

ACKNOWLEDGEMENTS

PLEASE READ CAREFULLY, INITIAL EACH PARAGRAPH AND SIGN BELOW.

I certify that the statements I have made on this application are true and correct. I understand that any misrepresentations made in this application will be sufficient cause for denial of employment with or discharge from The Company. I understand that nothing contained in this application, or the granting of an interview, is intended to be a contract of employment. I also understand that employment with The Company is "at-will" and that either of us may terminate the relationship at any time, for any reason, with or without cause. I certify that if employed by The Company, I will abide by all company rules and regulations.

I authorize The Company to investigate my background to determine my suitability for employment and use any information lawfully obtained for any employment-related purpose permitted by law. This investigation may include checking with the schools and employers I have identified, reviewing criminal conviction and driving records, and verifying any other relevant information about me. I release and waive any claims I may have against and indemnify The Company and any of the schools, former employers and other persons or entities for any loss or injury I may sustain as a result of any disclosure made related to this application.

The use, possession, or being under the influence of illegal drugs or alcohol while on Company time is prohibited and will result in disciplinary action, up to and including termination of employment. I hereby agree to any lawful drug or integrity testing or post-offer medical examination that may be required as a condition of employment and understand that refusal to submit to such testing during the course of my employment may result in disciplinary action, up to and including discharge. I authorize any physician, hospital, laboratory or collection site to release to The Company the results of any test or examination or other information which may be necessary to determine my ability to perform the duties of a job for which I am being considered, prior to employment or in the future during my employment with The Company.