Kitchen Employment

First Name

Last

Email Address

Street Address

Position(s) Applying for: (Line Cook, Prep Cook, Dishwasher, Food Runner)

Employer 1: Company Name

Phone No. with Area Code

Address

Salary

Job Title

Supervisor's Name & Title

Specific reason for leaving

Employer 2: Company Name

Phone No. with Area Code

Address

Salary

Job Title

Supervisor's Name & Title

Specific reason for leaving

Secondary School Name

Location

I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I hereby authorize this company to investigate any aspect of my prior educational and employment history. Furthermore, I understand that if I am hired, employment with this company is "at will", which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.