Your Name
*
First Name
Last Name
Today's Date
MM
DD
YYYY
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Email
*
Type of Employment
*
Date You Can Start Work If Hired
MM
DD
YYYY
Have you ever been employed by El Pollo Inka?
If yes, provide dates of employment, location and reason for separation from employment:
Are you legally eligible to work in the United States? (if offered employment, you will be required ot provide documentation et verify eligibility)
What are your skills and abilities?
Are you bilingual?
Highest Level of Education
Highschool Name
Graduated?
College Name
Graduated?
Graduate/Professional School
Graduated?
Trade/Correspondence School
Graduated?
Company Name
Employment from:
Type of Business:
Telephone Number:
May We Contact? If No, why not?
Supervisor's Name
First Name
Last Name
Position Held with the Company:
Duties & Responsibilities:
Reason for Leaving?
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain.
Company Name
Employment from:
Telephone Number:
May We Contact? If No, why not?
Supervisor's Name
First Name
Last Name
Position Held with the Company:
Duties & Responsibilities:
Reason for Leaving?
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain.
Company Name:
Telephone Number
May We Contact? If No, why not?
Supervisor's Name
First Name
Last Name
Position Held with the Company:
Duties & Responsibilities
Reason for Leaving?
What will this employer say was the reason your employment terminated?
How much notice did you give when resigning? If none, explain.
Have you ever been terminated or asked to resign? Yes or No. If Yes, how many times?
Has your employment ever been terminated by mutual agreement? Yes or No. If Yes, how many times?
Have you ever been given the choice to resign rather than be terminated? Yes or No. If Yes, how many times?
If you answered Yes to any of the above three questions, please explain the circumstanced of each occasion below:
Name #1
*
First Name
Last Name
Relationship
Reference's Telephone Number
Name #2
First Name
Last Name
Relationship
Reference's Telephone Number
APPLICANT CERTIFICATION
I understand that the Company may now have, or may establish, a drug-free workplace or a drug and/or alcohol testing program consistent with applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state, and local law, may be subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or drug tests is a condition of continual employment, and I agree to undergo alcohol and drug testing consistent with the company's policies and applicable federal, state, and local law.
If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning or notice, to conduct investigations of my property (including, but not limited to, files, lockers, desks, vehicles, and computers) and, in certain circumstances, my personal property.
I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality agreement, restrictive covenant, and/or conflict of interest statement.
I certify that all the information on this application, my resume, or any supporting documents I may present during any interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misinterpretation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal.
EL POLLO INKA IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISIONS IN THIS APPLICATION, IF HIRED, THE COMPANY MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE, OR REPRESENTATIVE OF THE COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT-EXPRESS OR IMPLIED-WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS A WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF THE COMPANY. IF HIRED, I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE COMPANY WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL.
I authorize El Pollo Inka or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking to the extent permitted by federal, state, or local law. I agree to complete any requested authorization forms for the background investigation which may be permitted by federal, state, and/or local law. If applicable and allowed by law, I will receive a separate written notification regarding El Pollo Inka's intent to obtain "consumer reports."
I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which may have resulted from the delivery or disclosure of the above-requested information. I hereby release from liability the company and its representatives for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the company to provide truthful information concerning my employment to future employers and hold the company harmless for providing such information.
If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this company employs only individuals who are legally eligible to work in the United States.
I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE ACCURATE AND COMPLETE.
DO NOT SIGN UNTIL YOU. HAVE READ ALL THE INFORMATION CONTAINED IN THE APPLICATION.
Applicant Signature
*
First Name
Last Name
Date
MM
DD
YYYY
Desired Pay
