Careers| Yummy Dishes |Sarasota| Old Salty Dog

Date

Name

First Middle Last Maiden

Present address

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

(No PO Boxes)

How long

OFFICE USE ONLY

Main phone #

Cell

Email

If under 18, please list age

Position applied for (1)

and Pay desired (2)

(Be specific)

Days/hours available to work

No Pref	Thur	Mon	Fri	Tue	Sat	Wed	Sun

How many hours can you work weekly?

Can you work nights?

Employment desired

FULL OR PART-TIME
PART-TIME ONLY
SEASONAL

When available for work?

High School

Yes
No

High School

NAME OF SCHOOL	LOCATION (Complete mailing address)	NUMBER OF YEARS COMPLETED	MAJOR & DEGREE

College

Yes
No

College

NAME OF SCHOOL	LOCATION (Complete mailing address)	NUMBER OF YEARS COMPLETED	MAJOR & DEGREE

Bus. or Trade School

Yes
No

Bus. or Trade School

NAME OF SCHOOL	LOCATION (Complete mailing address)	NUMBER OF YEARS COMPLETED	MAJOR & DEGREE

Professional School

Yes
No

Professional School

NAME OF SCHOOL	LOCATION (Complete mailing address)	NUMBER OF YEARS COMPLETED	MAJOR & DEGREE

DO YOU HAVE A DRIVER’S LICENSE?

Yes
No

What is your means of transportation to work?

Do you have any Health problems?

NO
YES

IF Yes briefly explain any impact they may have on your work.

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Please list two references other than relatives or previous employers.

Name	Position	Company	Address	Telephone

Name	Position	Company	Address	Telephone

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. You can attach additional sheets if necessary or a Resume to this email application.

Name of employer Address

Name of last supervisor

City, State, Zip Code Phone number

Employment dates

From	To

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of employer Address

Name of last supervisor

City, State, Zip Code Phone number

Employment dates

From	To

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of employer Address

Name of last supervisor

City, State, Zip Code Phone number

Employment dates

From	To

Your last job title

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present employer?

Yes
No

Did you complete this application yourself

Yes
No

If not, who did?

Section Break

PLEASE READ CAREFULLY APPLICATION FORM WAIVER

In exchange for the consideration of my job application by The Old Salty Dog Inc. (hereinafter called “the Company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of The Old Salty Dog, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and The Old Salty Dog Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contact.

Date

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.