Mexican Manhattan Restaurant Application for Employment Mexican Manhattan Restaurant is an equal opportunity employer. Please Print all information. GENERAL INFORMATION: Last Name: First Name: Middle Name: Present Address (number and street): City, State, and Zip Code: Telephone Number: Permanent Address (number and street): City, State, and Zip Code: Telephone Number: Have you ever been convicted, pled guilty, received deferred adjudication, or had a conviction set aside in a criminal matter (including offenses for driving while intoxicated or traffic offenses other than those involving non-injury traffic offenses or parking)? Answering "YES" will not disqualify you from consideration. (Circle one) YES NO Do you have any criminal charges pending against you? Answering "YES" will not disqualify you from consideration. (Circle one) YES NO Can you submit verification of your legal right to work in the United States? (Circle one) YES NO Position Desired: Minimum Salary Expected: Date You Can Start: Driver's License Number and State: Expiration Date: MILITARY SERVICE: If you have never served in the military, skip to the Education Section. Branch of Service: Date Entered Service: Date Discharged: Final Rank: Honors: EDUCATION: High School: Name of School: Location (City and State): Dates Attended: (From): (To): Major of Study: Degree: Year Graduated: College 1: Name of School: Location (City and State): Dates Attended: (From): (To): Major of Study: Degree: Year Graduated: College 2: Name of School: Location (City and State): Dates Attended: (From): (To): Major of Study: Degree: Year Graduated: College (Graduate): Name of School: Location (City and State): Dates Attended: (From): (To): Major of Study: Degree: Year Graduated: Other: Name of School: Location (City and State): Dates Attended: (From): (To): Major of Study: Degree: Year Graduated: ALCOHOL SALES: Have you ever worked in a position which required you to sell alcoholic beverages? (Circle one) YES NO Have you received certification training in an alcoholic beverage Program? (Circle one) YES NO Are you of legal age to sell alcoholic beverages? (Circle one) YES NO EMPLOYMENT HISTORY: Please list all employment starting with present or most recent employer. Full Name of Employer: Street Address: Telephone Number: City, State, Zip: Name of Supervisor: Date Hired: Date Separated: Reason(s) for leaving: Position and Major Duties: Starting Pay: Ending Pay: Full Name of Employer: Street Address: Telephone Number: City, State, Zip: Name of Supervisor: Date Hired: Date Separated: Reason(s) for leaving: Position and Major Duties: Starting Pay: Ending Pay: Full Name of Employer: Street Address: Telephone Number: City, State, Zip: Name of Supervisor: Date Hired: Date Separated: Reason(s) for leaving: Position and Major Duties: Starting Pay: Ending Pay: Full Name of Employer: Street Address: Telephone Number: City, State, Zip: Name of Supervisor: Date Hired: Date Separated: Reason(s) for leaving: Position and Major Duties: Starting Pay: Ending Pay: May we contact your present employer? (Circle one) YES NO Were you or have you been employed under a different name? (Circle one) YES NO Have you ever been discharged, asked to resign, or been terminated from previous employment? (Circle one) YES NO READ THE FOLLOWING STATEMENT CAREFULLY BEFORE SIGNING THE APPLICATION! I certify that all of the answers provided by me in this application are true and correct, and I understand that any misrepresentation of facts in this application or in any other corporate record of Mexican Manhattan Restaurant will be sufficient grounds for refusal of employment or cause for immediate dismissal without notice if I am already employed by the company. I authorize my former employer(s) and school(s) to provide any information that they may have concerning me, whether or not it is a matter of written record. If employed, I agree to conform to all policies and procedures of Mexican Manhattan Restaurant, and recognize that my employment and compensation can be terminated with or with out cause and with or without notice by either myself or Mexican Manhattan Restaurant. I consent to taking a physical examination, if requested by the company, and any future physical examinations as may be required by Mexican Manhattan Restaurant. Signature: Date: