Dylan's' Employment Application

Dylans Employment Application - An Equal Opportunity Employer

We look forward to adding new team members daily. Dylans looks for excited, hard-working individuals who are willing to learn and are eager to become part of our family. Please complete application and submit. back to main

GENERAL

February 09, 2012


Last Name	M. I.	First Name	Social Security Number


Present Address	City	State	Zipcode

Birthdate (If under 21), 19

Primary Phone

Are you able to legally be employed in the
United States of America? Yes No

(Proof of identity and legal authority to work in the U.S. is a condition of employment.)

Position to apply

Desired Salary

Who referred you to Dylans?

Available starting date

Availability	Sun	Mon	Tue	Wed	Thu	Fri	Sat
Days
Evenings

Have you ever been convicted of a felony? Yes No

If so, explain.

(Convictions will not necessarily exclude you from employment, but date and type of conviction may be considered for job placement.)

Relatives employed by Dylans:


Name	Location	Relationship

EDUCATION

Type of school	Name of School	Location of School	Courses Majored In	Years Completed	Diploma
High School					Yes No
College					Yes No
Other					Yes No

Are you TABC certified?
Yes No

Expiration Date

Are you Food Handler certified?
Yes No

Expiration Date

VOLUNTEER AND MILITARY EXPERIENCE

Volunteer Experience

Skills Acquired

Military Experience

Skill Acquired

BUSINESS EXPERIENCE - List most recent first


Past Employer 1	Phone Number			From		To


Address	City	State	Zipcode


Position	Salary	Reason for leaving


Past Employer 1	Phone Number			From		To


Address	City	State	Zipcode


Position	Salary	Reason for leaving


Past Employer 1	Phone Number			From		To


Address	City	State	Zipcode


Position	Salary	Reason for leaving

I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation in this application is sufficient cause for refusal to hire or dismissal if I have been hired regardless of date of discovery by the Company.

I understand that any employment is conditional upon a background check. I authorize the company to thoroughly investigate all statements contained in this application or resume, and I authorize my former employers to disclose information regarding my former employer, character and general reputation of the Company without giving me prior notice to such disclosure. In addition, I release the Company, any former employers, and all references listed within from any claims, demands, or liabilities arising out of or related to such investigation and/or disclosure.

I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create any employment contract. I further understand and agree that if I am hired any employment will be "AT WILL" and without fixed term and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the Company unless made in writing.

I understand that completion of this application does not indicate employment availability and does not obligate the Company to hire me. I agree to adhere to all Company work rules, policies and procedures. Dylans reserves the right to revise its policies or procedures, in whole or in part at any time.

Submitting this form will act as electronic signature.