Your information: Full name (First MI Last): Home telephone number: Business telephone number: Mailing address: How long at this address: Referred by: Position applied for: Earnings expected:   per hour per year Employment desired: Full Time   Part Time Date available to start work: Personal: Are you over 18 years of age: Yes   No If no, can you, after employment, submit a work permit: Yes   No   Not Applicable Do you have a legal right to work in the United States: Yes   No If you are not a legal citizen, can you submit proof of your legal right to work if you are offered a job: Yes   No   Not Applicable Have you worked for Restaurants, Inc. before: Yes   No If so, where and when: Supervisor's name: Do you have any outside activities which would keep you from work: Yes   No If yes, please explain: Education: Type of School Name/Address of School Courses Last Year Completed Degree Elementary 5 6 7 8 High School 9 10 11 12 College 1 2 3 4 Graduate School 1 2 3 4 Skills/Qualifications: List experience, qualifications, and skills which you feel would especially qualify you for a position with us: Availability: Please indicate the hours and days of the week you will be available for work: Days   Hours Monday   Tuesday   Wednesday   Thursday   Friday   Saturday   Sunday   Employment History: List below your former employers, beginning with the most recent Employer's Name:   Type of Business:   Address:   Supervisor Name Supervisor Title Supervisor Telephone   Nature of Work:   Your Title:   Date of Employment:   From To Starting Salary:     per hour per year Ending Salary:     per hour per year Reason for Leaving:   Employer's Name:   Type of Business:   Address:   Supervisor Name Supervisor Title Supervisor Telephone   Nature of Work:   Your Title:   Date of Employment:   From To Starting Salary:     per hour per year Ending Salary:     per hour per year Reason for Leaving:   Employer's Name:   Type of Business:   Address:   Supervisor Name Supervisor Title Supervisor Telephone   Nature of Work:   Title:   Date of Employment:   From To Starting Salary:     per hour per year Ending Salary:     per hour per year Reason for Leaving:   May we contact your present supervisor: Yes   No References: Please list three references that are not former employers or relatives. Name Phone Address Name Phone Address Name Phone Address     I certfity that the facts contained in the application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you and and all information concerning my previous employment and pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing the same to you. Restaurants, Inc. will keep information obtained confidential, except where such information is required to be released by law, order of court, or order authority. I understand and agree that if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause.