Application Instructions

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1 NEW HIRE APPLICATION Application Instructions Note: Interviews will be given Monday thru Thursday from 2:00-4:00 pm. If this is a problem, please call for an appointment. Thank you for your interest in employment with our company. We appreciate your application and look forward to the possibility of you joining our team. This sheet is for your information. Please keep it for your reference. Please complete the application forms. Print and complete all information so it may be easily read. Be certain that all forms are COMPLETELY filled out and that you sign them. Incomplete applications will not be considered. Use the abbreviation "N/A" if a particular provision or section in the form is not applicable to you. If printing the application online, please complete legibly and bring with you to the interview. No applications are accepted by mail or , only in person. After filling out the application, a manager will interview you briefly. You must complete this interview for any consideration of employment. DO NOT leave this application without an initial interview. If time does not allow, return for an interview another day. Your application will remain in our active files for a reasonable period of time. Should an appropriate opening occur, your application will be reviewed along with those of others. It is not necessary for you to contact this office regarding any job openings after you have completed your application. If you are among the most qualified applicants for a position another interview will be arranged. Employment decisions are made solely on the basis of qualifications to perform the work for which you are applying. Qualifications include education, training, work experience and maturity. There is a two year requirement of continuous employment in a fine dining restaurant with full liquor and wine knowledge for a server s application. The State of Texas requires that any person serving alcohol in this restaurant must be eighteen years old. Those applicants for other positions must be sixteen years old. Credentials and experience will be verified through schools, former employers, and applicable sources. A Background Check is done on or near the date of hire. A Drug Screening will be required at the time of hiring. As an Equal Opportunity Employer, we make decisions to hire and promote without regard to race, color, creed, national origin, sex, physical or mental handicap (unrelated to ability to do the job), or age (as defined by law). Our business is a subscriber to Workers' Compensation of Texas, pursuant to Article 8308, V.A.C.S. We appreciate your interest.

2 APPLICATION FOR INTERVIEW Today's date: Time: Applicant's Full Name: Job Applied For: Address: City: State: Zip Code: Phone: Cell: Home: Marital Status: # of Dependents: Date of Birth :( must be 16 years of age) Place of Birth: U.S. Citizen? Yes / No / Applied For Social Security Number: Texas Driver s License #: Condition of Health: List any physical limitations: Pre-existing Health Problems: Height: Weight: Convicted of a Felony? Yes / No Convicted of DUI/DWI? Yes / No Have you ever been convicted and pleaded guilty or no contest? Yes / No If you answered YES to any of the above three questions write an explanation with dates and sentences on the back of this page for each incident. Are you currently enrolled in a school or college? If so, what grade? Your GPA Did you complete High School? Where: When: Awards/Honors: Did you complete College? Where: When Major/Minor: List Extracurricular activities and hobbies: List last three places of employment starting with the most recent: Name of Employer Location Job Description Reason for leaving 1. Supervisor Name: Dates of Employment: Phone Name of Employer Location Job Description Reason for leaving 2. Supervisor Name: Dates of Employment: Phone Name of Employer Location Job Description Reason for leaving 3. Supervisor Name: Dates of Employment: Phone: Contact name and phone number: (in case of emergency) SCHEDULE AVAILABILITY AND REQUIREMENTS Available for Lunches, Monday thru Friday: Yes No some: M T W TH F Available for Dinners: Sun Mon Tues. Wed. Thurs. Fri. Sat. Number of shifts desired to work per week: Desired Earnings per week: To work in this restaurant, you must be able to carry a lunch and dinner schedule, and one of those must be a Friday or Saturday night. Also, you will be scheduled for special days i.e.: Mother's Day, New Year s Eve and others. You will be assigned a schedule and it will be your responsibility to work this schedule. In the event you need or want a shift off you will have the responsibility to find someone qualified to cover your shift and record this arrangement properly in the work transfer book. You are responsible to keep a list of phone numbers for this purpose. Will this cause any conflicts for you? Yes, I have some problems with this from time to time. No, I can work with this arrangement (Circle One) 1

3 1. Why do you want to work here? 2. Were you referred by someone? 3. What will you do with the money you make from this job? 4. What must you do to be successful in this job? 5. What problems do you have in dealing with customers? 6. If you have waited tables before, what part(s) of your service needs improvement or training? 7. What do you look for in service when you go out to a restaurant? 8. What are the accomplishments in your life, so far, that you are most proud of? 9. What three goals do you want to reach in the next two years? What reasons can you give of why you should be hired? 11. How long do you think you will work for the Taste of Texas? 12. Have you ever been arrested or pleaded guilty to a felony? 13. Are you currently on probation? APPLICANT S CERTIFICATION AND AGREEMENT: I certify that all information given on this application are true, correct and complete and that I am at least 16 years of age. I also certify that I have not withheld any other facts to add regarding my past work history, criminal record, or personal health. I understand any misrepresentation or omission of such facts will be sufficient cause for dismissal if hired. I further understand and agree that, if employed, the employment will be "at will". That is, either I or the company may end the employment relationship at any time for any reason or for no reason. Also, I understand that no representative of the company has the authority to enter into any agreement with me for employment for any specific period of time or make any agreement with me contrary to this agreement. Applicants Signature Date APPLICANT S DRUG TEST AGREEMENT: I understand as a condition of employment that I must take the drug test within the next 48 hours. Signature: Date: Time: 2

4 ACKNOWLEDGEMENT AND AUTHORIZATION FOR BACKGROUND CHECK Print Name: Other Known Names: Social Security Number: - - Date of Birth: / / Driver s License Number: Issued State: Current Address: City: State: Zip: I hereby authorize the obtaining of consumer reports and/or investigative consumer reports by the Requesting Company, Taste of Texas Restaurant, at any time after receipt of this authorization and throughout my employment, if applicable. To this end, I hereby authorize, without reservation, any law enforcement agency, administrator, local, state or federal agency, institution, school or university (public or private), information service bureau, employer, or insurance company to furnish any and all background information requested by 24/7 Background Check LLC, PO Box , Dallas, Texas 75374, another outside organization acting on behalf of the Requesting Company, and/or the Company itself. DISCLOSURE REGARDING CONSUMER AND/OR INVESTIGATIVE REPORT The Requesting Company may obtain information about you for employment purposes from a third party consumer reporting agency. A consumer report and/or an investigative consumer report may include information about your character, general reputation, personal characteristics and mode of living. These reports may contain information regarding your criminal history, social security verification, motor vehicle records ( driving records ), verification of your education or employment history, or other background checks. Further, you understand that information may be requested from various Federal, State, County and other agencies that maintain records concerning your past activities relating to your driving, criminal, civil, education, and other experiences. You have the right, upon written request made within a reasonable period of time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer 3

5 report obtained with regard to applicants for employment is an investigation into your employment and/or education history. The scope of this notice and authorization is allencompassing, however, allowing the Company to obtain consumer reports and investigative consumer reports now and throughout the course of your employment to the extent permitted by law, unless you otherwise revoke your consent by providing written notification to Company. As a result, you should carefully consider whether to exercise your right to request disclosure of the nature and scope of any investigative consumer report. You have the right to request A Summary of Your Rights under the Fair Credit Reporting Act. I understand by signing my name below, I am authorizing the background check as described above. I understand notices, documents, and communications may be provided electronically and will meet the requirements set forth under Federal and/or State law, as permitted by law. I agree that a facsimile ( fax ), electronic or printout of this authorization may be accepted with the same authority as the original. Applicant s Signature Date 4

6 MEDICAL HISTORY AND MOBILITY EVALUATION Applicant information statement: (to be read by the applicant). Before an offer of employment can be made the following sections must be completed. We are an Equal Opportunity Employer who affirmatively seeks to employ qualified handicapped individuals. The following evaluation will assist us in efforts to reasonably accommodate our work environment to your needs and to obtain a proper job fit. A. Do you have any physical or mental disabilities that would prevent you from performing the duties of the job applied for? Yes No B. If yes, what is the disability: C. Employment at this business requires all employees to be fit to perform any physical and / or mental activities related to their job, as well as to appear regularly and on time for work as assigned. In that regard, have you had or do you currently have any of the following ailments? A.I.D.S. Alcohol Addiction Back Trouble Breathing Trouble Cancer Circulatory Problem Diabetes Difficulty Bending or Squatting Dizzy/Blackouts Drug Addiction Yes No Epilepsy Headaches Heart Trouble Hernia High Blood Pr. Nervous Disorder Trick Joints Tuberculosis Ulcers Venereal Disease Yes No Describe any yes answers. List any medications you are now using. Name, address and phone # of physician having record and/or knowledge of your medical history. Name: Phone: Address City St. Zip May we contact your physician for information on your medical history? Yes No Will you authorize, if necessary, a release of your medical records to assist us in determining your fitness to perform activities related to the job(s) you are now applying for? Yes No 5

7 EMPLOYMENT STATUS AND AGREEMENT Are you currently employed? Yes No We routinely contact an applicant s current employer for reference checks. Would this pose any particular difficulty for you? Yes No If yes, please explain: Applicant s Certification and Agreement I certify that all information given on this application is true, correct and complete. I also certify that I have accounted for all my work experience, training, and physical / medical history. I understand that misrepresentation or omission of facts will be cause for cancellation of my consideration for employment, or dismissal, if employed. I authorize any inquiry to be made on any information contained in this application if I am considered for employment. I understand that employment may be conditioned upon a favorable health evaluation. I further understand and agree that, if employed, the employment will be at will. That is, either I or the company may end the employment relationship at any time for any reason or for no reason. Also, I understand that no representative of the company has the authority to enter into any agreement with me for employment for any specific period of time or make any agreement with me contrary to the forgoing. I further certify that I have no objections to the following conditions concerning my employment: 1. Available for overtime when scheduled. 2. Submitting to a physical and / or drug examination when requested by the company as stated in the company Drug Testing Policy. 3. Submitting to a polygraph examination when requested by the company. 4. Returning all company issued items at the time of termination. 5. Abiding by the rules and regulations of the company. 6. Available to work any shift, any department, or any job when assigned by the company at the prevailing rate at that time. 7. Submitting to a security search when requested by the company. Employee signature: Date: 6

8 APPLICANT S RELEASE OF MEDICAL RECORDS I,, do hereby authorize and give permission to all healthcare providers who have rendered medical care or related services to me, to give the, and any person duly acting on their behalf with written authorization of same, complete access to all of my medical records pertaining to any diagnosis or treatment of any injury, disease, illness, or medical condition. Permission is also given to said healthcare providers to fully discuss any diagnosis, treatment, condition, and prognosis with, or others acting on their behalf. This release is given for the purpose of facilitating the evaluation and processing of the undersigned applicant for employment at. A copy of this release shall be as valid as the original. Signed this the day of, 20 Applicant s signature Witness Signature Printed name of applicant Printed name of witness 7

9 RELEASE OF EMPLOYMENT RECORDS I,, hereby authorize TASTE OF TEXAS RESTAURANT, to investigate all facts contained in my application for employment with said business, and authorize the release of any and all information by my present and past employers wherever located, which may be required for a reference check. I further authorize all of my previous employers and current employer to give any and all information concerning my employment and other pertinent information which said employers may have, personal or otherwise, and I release all parties from all liabilities for any damages which may result from the furnishing of said information. A copy of this release shall be as valid as the original. Signed this the day of, 20 Applicant signature Witness Signature Printed name of applicant Printed name of witness 8

10 DRUG TESTS I,, understand and agree that the management of, may request a drug test for me, prior to my employment by said company or at any time after my employment. I understand the results of such a drug test, will not be revealed to anyone except management of. I further agree that I will be discharged without further cause if I fail to submit to such a scheduled test or if the results of any drug test conducted for me are unacceptable to the management of TASTE OF TEXAS RESTAURANT. I further agree to any future drug testing as described in the Employee Policies Manual. I further agree that I will not apply for and I waive all rights to unemployment compensation benefits should I be discharged for failing to receive an acceptable result from any drug test conducted for me. Signed this the day of, 20 Applicant s Signature Applicant s Printed Name Applicant s Social Security Number Signature of Witness Printed Name of Witness Notice to Applicants: Failure to sign the above consent form discontinues the employment process. 9

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