Restaurant_Application_Form

Madeira Restaurant Inc.

Employment Application

Applicant Information

First Name

Please enter your legal first name

Middle Initial

Middle initial if applicable

Last Name

Please enter your legal surname.

Address

Please provide your current address

Appt #

Appartment (unit #)

City

City

State

State

Zip Code

Phone Number

Please Provide your day-time phone number.

Mobile Number

OPTIONAL

Email

Confirm

Date Available

Please select the soonest date you could begin.

Full or Part time

Position

Desired Salary

Please enter your desired salary.
weekly / hourly

Are you a citizen of the United States?

Yes No

If no, are you authorized to work in the U.S.?

Yes No

Have you worked for this company in the past?

Yes No

If yes, when?

Have you ever been convicted of a felony?

Yes No

If yes, explain:

Education

High School:

Diploma

Collage

Degree

Other / Graduate

Degree

Certifications

ServSafe

Yes No

Alcohol Safety (TIPS)

Yes No

References

Reference 1:

Full Name

Relationship

Company

Phone Number

Address

Reference 2:

Full Name

Relationship

Company

Phone Number

Address