Contact Lakewood Ranch Lunch Restaurants

Employee Application Form

General Information

First Name

Middle Initial

Last Name

Home Telephone

Mailing Address

City

State

Zip Code

Other Telephone

E-Mail Address

Are you legally entitled to work in the U.S.?

Yes

Position

Position or Type of Employment Desired

Will Accept

Shift Preference

Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation?

Yes

Salary Desired

Date Available

Education and Training

High School Graduate or General Education (GED) Test Passed?

Yes

If no, list the highest grade completed

College / Business School / Military — Entry 1

Name and Location

Dates Attended — From (Month/Year)

Dates Attended — To (Month/Year)

Credits Earned — Quarterly or Semester Hours

Credits Earned — Other (Specify)

Graduate?

Yes

Degree & Year

Major or Subject

College / Business School / Military — Entry 2

Name and Location

Dates Attended — From (Month/Year)

Dates Attended — To (Month/Year)

Credits Earned — Quarterly or Semester Hours

Credits Earned — Other (Specify)

Graduate?

Yes

Degree & Year

Major or Subject

Occupational Licenses, Certificates & Registrations

License / Certificate / Registration

License — Number

License — Where Issued

License — Expiration Date

Languages Read, Written or Spoken Fluently Other Than English

Work Experience — Employer 1 (Most Recent)

Employer

Telephone Number

From (Month/Year)

Address

Job Title

Number of Employees Supervised

To (Month/Year)

Specific Duties

Hours Per Week

Last Salary

Supervisor

Reason for Leaving

May We Contact This Employer?

Yes

Work Experience — Employer 2

Employer

Telephone Number

From (Month/Year)

Address

Job Title

Number of Employees Supervised

To (Month/Year)

Specific Duties

Hours Per Week

Last Salary

Supervisor

Reason for Leaving

May We Contact This Employer?

Yes

Work Experience — Employer 3

Employer

Telephone Number

From (Month/Year)

Address

Job Title

Number of Employees Supervised

To (Month/Year)

Specific Duties

Hours Per Week

Supervisor

Last Salary

Reason for Leaving

May We Contact This Employer?

Yes

Work Experience — Employer 4

Employer

Telephone Number

From (Month/Year)

Address

Job Title

Number of Employees Supervised

To (Month/Year)

Specific Duties

Hours Per Week

Last Salary

Supervisor

Reason for Leaving

May We Contact This Employer?

Yes

Certification

I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal.

Signature of Applicant

Date

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Employment Application

General Information

Position

Education and Training

College / Business School / Military — Entry 1

College / Business School / Military — Entry 2

Occupational Licenses, Certificates & Registrations

Work Experience — Employer 1 (Most Recent)

Work Experience — Employer 2

Work Experience — Employer 3

Work Experience — Employer 4

Certification