CAREERS - World Empanadas

Applicant Name*

First Last

Position Applied For*

(list only one)

Telephone Number*

Alternate/Cellular Telephone Number

Present Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How long have you lived there

YYYY

MM

DD

Email*

Are you under the age of 18?*

Yes
No

If under the age of 18, can you produce the necessary work certificate at the time of employment?*

Yes
No

Type of employment desired?*

Full-time
Part-time

(Specify Hours)*

Are you willing to work overtime?*

Yes
No

Date on which you can start work if hired*

Have you previously applied for employment at World Empanadas?*

Yes
No

If Yes, when and where did you apply?

Have you ever been employed by World Empanadas?*

Yes
No

If Yes, provide dates of employment, location and reason for separation from employment.

If applicable, below list any other names by which you have been known which may be necessary to allow us to confirm your work and educational record. For example, change of name, use of an assumed name, nickname, etc.

Work Experience

Name*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type of Business

Phone*

Dates Employed From*

MM

DD

YYYY

Dates Employed To*

MM

DD

YYYY

Job Title

Duties

Supervisor's Name

May we contact?

Yes
No

If No, why not?

Wages Start

Final

Reason for Leaving?

What will this employer say was the reason your employment terminated?

Were you ever disciplined? If so, for what?

How much notice did you give when resigning? If none, explain.

Have you ever been terminated or asked to resign from any job?

Yes
No

If Yes how many times?

Has your employment ever been terminated by mutual agreement?

Yes
No

If Yes how many times?

Have you ever been given the choice to resign rather than be terminated?

Yes
No

If Yes how many times?

If you answered Yes to any of the above three questions, please explain the circumstances of each occasion.

DRIVING INFORMATION [Optional]

Do you have a current valid driver’s license?

Yes
No

If yes, License No.

State

Expiration Date

If you do not have a driver’s license for the state in which you currently reside, why not?

Has your license ever been suspended or revoked?

Yes
No

If yes, explain

Do you have personal automobile insurance?

Yes
No

If no, explain

Have you ever been denied personal automobile insurance or has it ever been terminated or suspended?

Yes
No

If yes, explain

Applicant Signature*

First Last

Date*

MM

DD

YYYY

APPLICATION FOR EMPLOYMENT

Work Experience

DRIVING INFORMATION [Optional]