Eddie Merlot's Employment Application
Notice to Applicant:
We are an equal opportunity employer and our policy is to comply with all employment laws, federal, state or local in origin.
Our employees, as well as job applicants, are entitled to reasonable accommodation, if necessary, to perform a particular job function as well as the completion of the employment form.

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NOTE – REQUIRED FIELDS ARE *

Applicant

*Last Name *First Name Middle Initial *Today's Date *Phone Number *E-Mail Address

Location applying for

- Select Location - Burr Ridge Cincinnati Columbus Fort Wayne Indianapolis Lincolnshire Louisville Warrenville Eddie Merlot's Corporate        *Location

Address

AKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKONORPAQURISASCSDTNTXUTVAVTWAWIWVWY *Address *City *State *Zip Code *Years lived here If residing at current address for less than 2 years, please provide previous address: AKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKONORPAQURISASCSDTNTXUTVAVTWAWIWVWY Previous Address Previous City Previous State Previous Zip Years lived here

Eligibility

Yes No *Are you legally authorized to work in the U.S.? Yes No *Are you 18 or older?

Work

Bartender Server Busser / Server Assistant Food Runner Host / Hostess Dish Machine Operator Line Cook Pantry Cook Prep Cook Housekeeping Manager * Check all position(s) you are interested in

*What days and times are you available to work?

*Date when you will be available for work

*Expected hourly rate

*How many hours per week you expect to work

Yes No

*Are you willing to work holidays?

Yes No

*Are you willing to stay late in an emergency?

Transportation

*How long will it take you to get from home to work? *What type of transportation will you use?

Employment Experience (Most current first)

Name of Company Date employment started Date employment ended Name of supervisor Phone number Job title Reason for leaving Salary/Wages Name of Company Date employment started Date employment ended Name of supervisor Phone number Job title Reason for leaving Salary/Wages Name of Company Date employment started Date employment ended Name of supervisor Phone number Job title Reason for leaving Salary/Wages

Education:

Yes No *High School 1 *Years attended *Did you graduate? Yes No High School 2 Years attended Did you graduate? Yes No College 1 Years attended Did you graduate? Subjects studied Yes No College 2 Years attended Did you graduate? Subjects studied Yes No Trade or Business School 1 Years attended Did you graduate? Subjects studied Yes No Trade or Business School 2 Years attended Did you graduate? Subjects studied

Special Training

Yes No *Any special skills, proficiencies, or certifications?

References

*Name *Company *Position *Phone # *Yrs. Known *Name *Company *Position *Phone # *Yrs. Known *Name *Company *Position *Phone # *Yrs. Known

*How did you hear about Eddie Merlot's?

*How did you hear about us

Past History

Yes No *Have you ever been convicted of any criminal offense other than minior traffic violations If yes, please explain in detail (A conviction record does not necessarily disqualify you from employment; factors such as the date of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account)

Drug Free Policy

Yes No *Eddie Merlot's is a drug free work place. Do you understand that we are committed to provide for its employees and guests a drug free work place at all time?

Electronic Signature

I affirm that all information in this application is true and complete. Any misrepresentation, false statements, or omission of requested facts shall be grounds for refusal of employment or, if hired, dismissal from employment, no matter when discovered. I understand that my application will remain active for 90 days from the date received. I understand that if I am hired, I will be required to provide proof of identity and that Federal immigration laws require me to complete an I-9 form to document authorization to work in the United States. I understand that Eddie Merlot's maintains a drug free workplace policy and agree to comply with the Drug Free Workplace policy if hired. I authorize any person, organization, or company listed on this application to furnish you any and all information concerning my previous employment, education, and qualifications for employment. I also authorize you to request and receive such information and release all parties from liability for damage that may result from furnishing the same to you. I understand and acknowledge that this employment application and any other company documents are not contracts of employment. I understand and acknowledge that my employment amnd compensation can be terminated with or without cause, and with or without notice, at any time at the option of the company or myself. I understand that no representative of the company has the authority to make any modifications, either verbally or in writing, to the contrary.

Yes No *Have you read and agree to the statements above? *Type your name in the box above to sign this application