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First Name: |
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Middle Initial: |
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Last Name: |
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Street Address: |
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City: |
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State: |
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Zip Code: |
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Phone Number: |
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E-mail:: |
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| How did you learn about employment opportunities with Mi Cabana Mexican Restaurants?* |
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| Have you ever been employed by Mi Cabana Mexican Restaurants? |
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| If you have been employed, when/where/supervisor's name? |
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| Are any of your relatives currently employed by Mi Cabana Mexican Restaurants? |
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| If hired, can you provide proof that you are eligible to work in the United States?* |
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| Are you at least 16 years old? |
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| Have you ever been convicted of a crime? |
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| If you have been convicted of a crime, please give date, place, and nature of crime (Convictions will not necessarily disqualify applicant; each case is considered individually) |
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Educational Background |
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| High School |
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High School Address
(City, State, Postal Code) |
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| High School Education Level |
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| College or University |
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College Address
(City, State, Postal Code) |
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| College Education Level |
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| Other Education |
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Other Address
(City, State, Postal Code) |
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| Other Education Level |
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Work Experience (Must provide two previous employers) |
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| Employer 1 Name: |
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| Employer 1 Address (City, State, Postal Code): |
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| Employer 1 Phone: |
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| Employer 1 Start Date (MM/DD/YYYY) : |
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| Employer 1 End Date (MM/DD/YYYY): |
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| Employer 1 Position Title: |
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| Employer 1 Reason for Leaving: |
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| Employer 1 Position Description: |
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| Employer 1 Supervisor Name: |
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| Employer 1 Supervisor Title: |
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| Employer 2 Name: |
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| Employer 2 Address (City, State, Postal Code): |
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| Employer 2 Phone: |
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| Employer 2 Start Date (MM/DD/YYYY) : |
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| Employer 2 End Date (MM/DD/YYYY): |
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| Employer 2 Position Title: |
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| Employer 2 Reason for Leaving: |
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| Employer 2 Position Description: |
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| Employer 2 Supervisor Name: |
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| Employer 2 Supervisor Title: |
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| May we contact your present employer concerning your work experience?* |
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| May we contact your prior employer(s) concerning your work experience?* |
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Current Employment Desired |
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| Position Desired: |
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| Date available to begin work (MM/DD/YYYY)? |
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| Will you work nights? |
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| Will you work weekends? |
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| Will you work holidays? |
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| Are you willing to work overtime as required? |
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| Current wage/salary desired (Whole numbers only please) |
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References |
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| Reference 1 Name: |
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| Reference 1 Phone Number |
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| Reference 1 Business and Position |
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| Reference 1 Years Acquainted |
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| Reference 2 Name: |
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| Reference 2 Phone Number |
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| Reference 2 Business and Position |
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| Reference 2 Years Acquainted |
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| Reference 3 Name: |
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| Reference 3 Phone Number |
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| Reference 3 Business and Position |
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| Reference 3 Years Acquainted |
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Certification & Agreement |
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"I certify that all information on this form is true & correct. I also certify that I have accounted for all of my work experience and training on this application. I further understand that this is an application for employment and that no employment contract is being offered. I understand that if I am employed, such employment is for an indefinite period of time and that * Mi Cabana Mexican Restaurants can change wages, benefits, and conditions at any time. I further understand my employment can be terminated with or without cause and with or without notice at any time at the option of either * Mi Cabana Mexidan Restaurants or myself. I have read and understand the above."
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| Date: |
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| Initials: |
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