PERSONAL INFORMATION
First Name*
Last Name
Address
City
State
Zip Code
Phone Number
Email
Position(s) Applying For:
Availability
Full Time Part Time Night Work Day Work
How or by whom were you referred:*
QUESTIONS MARKED “*” ARE DESIGNED TO EXPEDITE THE INTERVIEW AND HIRING PROCESS BUT ARE “OPTIONAL” AT THIS TIME. OUR COMPANY DOES NOT DISCRIMINATE ON ANY BASIS. IF YOU FEEL THAT ANY OF THE QUESTIONS ARE DISCRIMINATORY, YOU ARE FREE TO LEAVE THEM UNANSWERED UNTIL SUCH TIME AS YOU HAVE BEEN OFFERED A POSITION CONTINGENT UPON YOUR ABILITY TO LEGALLY ACCEPT SUCH AN OFFER.
Can you, after employment submit verification of your legal right to work in the United States?
Yes No
Do you have any friends or relatives working at Hula’s Bar & Lei Stand whom you wish to use as a personal reference
Yes No
If you have answered yes to the previous question, indicate the name(s) here:
Apart from absences for religious observances, are there any days or nights you cannot work?
Yes No
if yes, please explain
*Do you have any special skills, speak a language(s) other than English, or have special trade skills relevant to the position you are applying for?
Yes No
if yes, please explain
EDUCATION
Have you graduated from high school?
Yes No
High School Attended:
Did you attend college?
Some College Associate Degree Bachelors Degree
Masters Degree
College Attended and subject(s) studeid:
REFERENCES
PLEASE DO NOT USE RELATIVES OR PAST EMPLOYERS. Please list name, address, telephone and occupation of at least two (2) References. *
EMPLOYMENT
Company Name
Company Address
Company Telephone Number:
Position:
Supervisor:
Wage:
Start Date:
End Date:
Work Performed:
Reason for leaving:
Company Name
Company Address
Company Telephone Number:
Position:
Supervisor:
Wage:
Start Date:
End Date:
Work Performed:
Reason for leaving:
Company Name
Company Address
Company Telephone Number:
Position:
Supervisor:
Wage:
Start Date:
End Date:
Work Performed:
Reason for leaving:
ACKNOWLEDGEMENT
I certify that the information contained in this application is true and correct to the best of my knowledge, and understand that any omission, or false or misleading statement, whenever discovered, regarding the information provided or requested in this application or during the hiring process is grounds for disqualification from further consideration for employment or dismissal from employment, if I am hired.*
I authorize the Company to verify all references and information provided by me in this application and or during the hiring process and release the Company and any other person or company from any claim or liability regarding any information or opinion requested or supplied. I understand that any offer of employment is subject to a satisfactory reference check.*
If hired, I understand that employment is “at will” and can be terminated at any time, with or without cause and with or without notice.*
I understand and agree that the Company may require me to complete a controlled substances screening test to verify that I am not currently using an illegal drug or other controlled substance to continue my employment. The Company will pay the cost for any post-hire drug testing. I authorize the individual(s) conducting the test and any laboratory analyzing any specimen for controlled substances testing to release the results of the examination and/or test results to the Company in accordance with state and federal laws. The Company will keep such test results confidential, in accordance with state and federal laws.*
If hired, I agree to abide by all rules, policies and procedures of the company and understand that I will be subject to discipline, up to and including termination.*
I agree to all the terms stated on this form (required)
Agree
Date:
Please Type Name: This will be acknowledged as a digital signature
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