reevrer= ] APPLICATION = fSa=™= HALT TICM FOR — EMPLOYMENT [EUPCOYEE WOMBER %-IG-D (Please answer all questions) [SEPARTMENT a WEARE AN EQUAL OPPORTUNITY EMPLOYER |" Sx owunon one| NOTICE: Applicant should read the flowing information carefully before ling out any af the quesons on th frm. We are ‘an equal opportanty employer and fulysubsrbe tl the principles of eql opportunity Is ou polcy to seek and employ the ‘best quad personnel in all poston without regard to race, exo, eign, age, sex dab, rational agnor any oer Basis ‘ade unlawil by eter sate or federal iw. tis ox posey to comply wha feral an sale employment statues. nfrmation equostd antes appleston wil ot be used for any purpose prohibited by am Cov. Eypenia, Orin. $209 Cary. Rd. Va 4. (517) 254-41BH Howie ve youn ste sv ative’ 1D GeOAD feyeuttyealdorie? Yee No rt ate ae torn OC, ‘under age 18, how many hours per week are you employed etsewnere?_\ 2) hours. frow tbounanerioveyberessaronny?) Yer \XNO Prvaenane LCN Coe 7 Do yourevewansgetatontoandtomant? ves No Areyovautateedtowak RUG LIS? Wes ono wr coo Ponti epider? AIL WCE ge youcan sat O20 1 19 say desired Aeyouseeyegtor YFulTine PatTine Temporary Daye Only CNG Ono Doyen no recommended you fo this peston? EDUCATION SCROOINS TONE FS ROGRESS OF SCOOT | SRIDE DEGREE | GRADUATE ‘ComPuereD | Yes" "NO fer sro! Camdiuin -Froahar a0 HOA _|HiGh Scnoo}| Y — TUL_W . Boatgomen idigioria, lestgrortnteny LAL [Acai welts a % oS Hodion & a ne —— hayes] ava Tae [Fear Ty — at ia [moss ves Kno l ‘PLEASE CHECK THE KIND OF WORK YOU HAVE DONE: anand ‘Dettan Pty Cone at St Beotreser Deneste or Ve Sam Sern Bern lp in Pane vie Su Seren oer Homers wes oak vce oper Seroerer Sook per News ‘yp eanter Panty Nogsatle cook CONTINUED ON REVERSE SIDE-PREVIOUS RESTAURANT EXPERIENCE (UST BELOW YOUR LAST FOUR EMPLOYERS, STARTING WITH MOST RECENT ONE FIRST) cai YOUR acne ve EARL [Reson FoR EMPLOYMENT -LastCompany Fest | pusivess | posinion |supeRvisor| TUE DATES |SALARY| LEAVING ira rae ——— = ta 4 Maran Eee SRG] ean [ars as sete a a Se Freya a pa aay | one Job ee [eon —— [ey oe pacar fears —— — = = : a [Bate cor a ‘Are there any jb dues that you would unable to perfor? _NO. {is there anything we could do to accommodate you so you could perform all the required job dies? _NNO. Have you ever appieato ths company below? Yee \KNo yes, where? When? ‘Are you now employes? ies No __ Telephone number IN CASE OF EMERGENCY NOTIFY ~ NAME, ADDRESS, PHONE) RELATIONSHIP, IF ANY Acne CU 00 Clare Rd. S17 29S" 20521 MO 1 authorize investigation ofl statomans contained in Wis application 2. understand hat misrepreseaton x omission of fats calles for cause for dismissal and hat my employments substataly dependent on rut arewars to the frgang nques. 8. have ead hese statements and anevers to these inquires. WCYee “No spate QUT. “OCLs ‘A sorvice of Wisconsin Restaurant Association » Madison, WI