Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email Address:
*
Emergency Contact
*
Emergency Contact
If hired, can you provide proof that you are legally able to work in the United States?
*
YES
NO
How were you referred to us?
*
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Referral
Employment Agency
Walk-In
Other
Have you ever been convicted of a criminal offense (felony or misdemeanor)? Note: an affirmative answer will not necessarily result in disqualification for employment.
*
YES
NO
If yes please state the nature of the offense(s), date(s), city, state and disposition of the offense.
List any relatives or friends employed by Clay's Restaurant
*
Position Desired
*
What days and hours are you available for work?
*
Are you available to work overtime if necessary?
*
YES
NO
Are you over 18 years of age?
*
YES
NO
When are you available to begin work?
*
MM
DD
YYYY
What knowledge, special skills and/or individual capabilities do you have which especially prepare you for the position applied for?
*
High School or Trade School:
*
Name and City of School.
Number of years completed?
*
Did you graduate?
*
YES
NO
College or University
*
Name and City of School
How many years did you complete?
*
Did you graduate?
*
YES
NO
What was your major or area of study?
*
1. Previous Employer Company Name
*
Phone
*
(###)
###
####
Start Date
*
MM
DD
YYYY
End Date
*
MM
DD
YYYY
Salary
*
Job Title
*
Supervisor
*
May we contact this employer?
*
YES
NO
Phone
*
(###)
###
####
Start Date
*
MM
DD
YYYY
End Date
*
MM
DD
YYYY
1. Personal Reference, not related to you and who you have known for at least (5) five years.
*
Reference Phone
*
(###)
###
####
2. Personal Reference, not related to you and who you have known for at least (5) five years.
*
1. The information that I have provided on this application is accurate to the best of my knowledge and may be verified by Clay's Restaurant or its agents.
*
2. I authorize all the schools, persons and organizations named in this application to provide any relevant information in their possession or knowledge to the agents of Clay's Restaurant, for use in deciding whether or not to offer me employment and specifically waive any required written notification. I hereby release Clay's Restaurant, my former employers and all other persons from any and all claims, demands, or liabilities arising out of or in any way related to such inquiry or disclosure.
*
3. I understand that Clay's Restaurant is committed to maintaining a drug and alcohol free work place. Accordingly, I may be subject to a pre-employment blood test, urinalysis or other drug/alcohol screening. I further understand that if employed, I may be subject to such a drug and alcohol screening if the Clay's Restaurant has reasonable suspicion to believe that I am under the influence of a drug or alcohol. My consent to submit to such a test is required as a condition of employment and my refusal to consent shall result in a refusal to hire or, if already employed, termination.
*
4. I understand and agree that any misrepresentation or omission of facts in this application will be justification for refusal or termination of employment, regardless of the time elapsed before discovery.
*
5. I understand and agree that the employment for which I am applying for is at-will and such employment may be terminated at any time with or without cause, without prior notice, by either myself or Clay's Restaurant. There will be no agreement, express or implied between Clay's Restaurant and me for any specific period of employment, nor for continuing or long term employment, unless made in writing, signed by an authorized representative of Clay's Restaurant.
*
6. I have placed my signature in the space provided below only after I have completed the entire application to the best of my ability and have carefully read the statements above.
*
Applicant Name
*
This will serve as a digital signature for this application.
First Name
Last Name
Date of form submission.
*
MM
DD
YYYY
