Employment Application

EMPLOYMENT APPLICATION FOR PART-TIME, HOURLY POSITIONS
We are an equal opportunity employer. Employment decisions are made without regard to race, color, religion, national origin, age, sex,
disability, or other protected status in accordance with local, state, and federal laws.

Last Name* required field

First Name* required field

Address* required field

Phone* required field

Email* required field

Location* required field

Desired Position(s)

Date your can start* required field

WORK & JOB AVAILABILITY (Check all that apply)

Monday
Day	Evening
Tuesday
Day	Evening
Wednesday
Day	Evening
Thursday
Day	Evening
Friday
Day	Evening
Saturday
Day	Evening
Sunday
Day	Evening

Able to work holidays (except New Year's Day, Labor Day, Thanksgiving Day, and Christmas)?

Do you have reliable transportation to work?

Are you 18 or older?

Are you 21 or older?

If hired, can you provide proof that you are legally authorized to work in the U.S.

EDUCATION

HIGH SCHOOL

Name and Location

List Degree or Major/Subjects of Study

Number of Years Completed

COLLEGE or UNIVERSITY

Name and Location

List Degree or Major/Subjects of Study

Number of Years Completed

SPECIAL TRAINING or TRADE SCHOOL, etc.

Name and Location

List Degree or Major/Subjects of Study

Number of Years Completed

OTHER EDUCATION

Name and Location

List Degree or Major/Subjects of Study

Number of Years Completed

EMPLOYMENT EXPERIENCE(Please start with your most recent employer.)

EMPLOYER 1 (most recent)

Employer

Address

Phone Number

Dates From (Mo/Yr)

Dates To (Mo/Yr)

Position

Rate of Pay

Supervisor Name

Supervisor Title

Reason for Leaving

Job Duties

EMPLOYER 2 (most recent)

Employer

Address

Phone Number

Dates From (Mo/Yr)

Dates To (Mo/Yr)

Position

Rate of Pay

Supervisor Name

Supervisor Title

Reason for Leaving

Job Duties

EMPLOYER 3 (most recent)

Employer

Address

Phone Number

Dates From (Mo/Yr)

Dates To (Mo/Yr)

Position

Rate of Pay

Supervisor Name

Supervisor Title

Reason for Leaving

Job Duties

EMPLOYER 4 (most recent)

Employer

Address

Phone Number

Dates From (Mo/Yr)

Dates To (Mo/Yr)

Position

Rate of Pay

Supervisor Name

Supervisor Title

Reason for Leaving

Job Duties

What knowledge, skills, or capabilities do you have that have prepared you for the position(s) you are applying for?

EMPLOYMENT REFERENCES

Name

Relationship

Phone

How did you hear about Eddie Merlot's?

List any relatives employed by Eddie Merlot's and how you are related

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 1-9 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 and 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.

Have you read and agreed to the statements above?
Yes No

Signature* (type your full name)required field