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Position Applied For: |
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Date: |
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First Name:
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M. I.
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Last Name:
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Email: |
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Present Address:
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City
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State: |
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Zip:
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Home Phone:
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Cell Phone:
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If you are under 18 Years of age, can you furnish a work permit? |
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Are you authorized to work in the United States and able to provide proper documentation, if hired? (Proof of employment eligibility or immigration status will be required upon employment) |
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How were you referred to us? |
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If other, please describe: |
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Have you been convicted of a felony crime in the past 10 years? |
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If so please describe. (Please note, such a conviction may be relevant if job-related, but does not necessarily bar you from employment.) |
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Availability |
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Would You Prefer: |
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| Please provide your schedule availability: |
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| Available Hours |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
Sunday |
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From
to
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From
to
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From
to
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to
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From
to
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From
to
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From
to
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| Note: Work Schedules are based upon the needs of the business and may be subject to change on a weekly basis and as needed |
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Education |
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High School |
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Name of School |
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Major Subject |
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Last Year Attended |
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Graduated |
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Degree |
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College |
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| Name of School |
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Major Subject |
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Last Year Attended |
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Graduated |
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Degree |
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Other |
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| Name of School |
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Major Subject |
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Last Year Attended |
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Graduated |
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Degree |
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Skills and Work Experience: |
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| Summarize below and special skills and qualifications acquired from other employment or other experiences that may qualify you for work with our Company. |
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Employment History
All questions in this section must be completed in order for your application to be considered. Since we make every effort to contact previous employers, the correct telephone numbers of past employers are important. Please list your employment starting with your most recent position. |
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Name of Company |
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Address of Company |
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City |
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State |
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Zip |
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Start Date
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End Date
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Position(s) Held:
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Pay Wage / Salary:
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Supervisors Name & Title
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Supervisors Phone Number
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Reason For Leaving
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Duties and Responsibility
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Name of Company
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Address of Company
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City
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State
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Zip
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Start Date
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End Date
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Position(s) Held:
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Pay Wage / Salary:
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Supervisors Name & Title
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Supervisors Phone Number
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Reason For Leaving
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Duties and Responsibility
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Name of Company
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Address of Company
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City
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State
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Zip
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Start Date
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End Date
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Position(s) Held:
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Pay Wage / Salary:
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Supervisors Name & Title
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Supervisors Phone Number
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Reason For Leaving
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Duties and Responsibility
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Have you ever been discharged or asked to resign by an employer? |
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References: (Do not list any relatives) |
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Name
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Address
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Phone
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Relationship
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Name
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Address
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Phone
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Relationship
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Name
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Address
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Phone
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Relationship
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| Initials
I certify that all answers given by me are true, accurate and complete. I understand that the falsification, misrepresentation or omission of fact on this application (or any other accompanying or required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered. |
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| Initials
I authorize Harpoon Hanna's to make such investigations and inquiries of information provided herein (and attached hereto), and other matters related thereto as may necessary. I release Harpoon Hanna's and its officers, employees, agents, and heirs, from all liability in connection with these actions. I hereby release Harpoon Hanna's officers, employees, representatives, franchisees and licensees, employers, schools and other persons, institutions or businesses responding to investigations or inquiries from all liability and responding to inquires in connection with my application for employment. |
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| Initials
I understand that nothing in this application, or in any prior or subsequent written or oral statement, creates a contract of employment or any rights in the nature of a contract. I agree and understand that if I am hired by Harpoon Hanna's, my employment will be "at-will" for an indefinite period of time, and may be terminated at any time, with or without cause or notice, at the option ofHarpoon Hanna's or myself. I understand that I have the right to the end my employment at any time and that Harpoon Hanna's retains the same right. I further understand and agree that nothing in this application is intended as, or shall constitute a contract or guarantee of employment. |
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I agree to the terms stated above and realize that the submission of this form is considered signed when transmitted |
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| Signature:
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Date:
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DOB:
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