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Application for the Diaspora Restaurant Group
This application is current for sixty (60) days. If we have not contacted you at the end of sixty days, and if you still wish to be considered for employment, it will be necessary for you to fill out a new application.
Restaurant for which you are applying:
*
Abay Ethiopian Cuisine
Alma Pan-Latin Kitchen
Either
Personal
Name (First, Middle, Last)
*
Home Address
*
City
*
State
*
Zip Code
*
Phone Number
*
Are you under 18?
Yes
No
If yes, what is your age?
Date available for employment
*
Email Address
*
?
Hours available for employment
*
10am-3pm
4pm-11pm
Both
Position for which you are applying
*
Citizen of the US?
*
Yes
No
If you are not a citizen of the U.S. are you an alien lawfully admitted and authorized to work in the U.S.?
Yes
No
n/a
How were you referred?
*
Newspaper
Friend
Other
Have you ever been convicted of a criminal offense? (A conviction will not necessarily ban you from employment.)
*
Yes
No
If convicted, when?
Nature of Offense
List relatives/friends working for us
Employment History (please list up to four past jobs)
Company Name
Company Address
Company Phone Number
Dates Employed From
To
Your Position
Responsibilities
Salary Start
Salary End
Name and Title of Supervisor
Reason For Leaving
Resigned
Terminated
Other
If other, why?
May we contact?
Yes
No
If no, why?
Company Name
Company Address
Company Phone Number
Dates Employed From
To
Your Position
Responsibilities
Salary Start
Salary End
Name and Title of Supervisor
Reason For Leaving
Resigned
Terminated
Other
If other, why?
May we contact?
Yes
No
If no, why?
Company Name
Company Address
Company Phone Number
Dates Employed From
To
Your Position
Responsibilities
Salary Start
Salary End
Name and Title of Supervisor
Reason For Leaving
Resigned
Terminated
Other
If other, why?
May we contact?
Yes
No
If no, why?
Company Name
Company Address
Company Phone Number
Dates Employed From
Your Position
To
Responsibilities
Salary Start
Salary Start
Salary End
Name and Title of Supervisor
Reason For Leaving
Resigned
Terminated
Other
If other, why?
May we contact?
Yes
No
If no, why?
Education (fill out any that apply)
Name and Address of High School (1)
Did you graduate?
Yes
No
Highest Year Achieved
Name and Address of High School (2)
Did you graduate?
Yes
No
Highest Year Achieved
Name and Address of College (1)
Did you graduate?
Yes
No
Highest Year Achieved
Name and Address of College (2)
Did you graduate?
Yes
No
Highest Year Achieved
Name and Address of Graduate School (1)
Did you graduate?
Yes
No
Highest Year Achieved
Name and Address of Graduate School (2)
Highest Year Achieved
Did you graduate?
Yes
No
Other Training
Skills
What special skills or abilities do you possess that would qualify you for work with our organization?
Military (if applicable)
Complete this section if you served in the US Armed Services. Describe your duties and any special training.
Rank at Discharge
Branch of service
Period of active duty from
To
Date of Discharge
References
Name
Address
Phone Number
Occupation
Years Known
Reference Two
Name
Address
Phone Number
Occupation
Years Known
Reference Three
Name
Address
Phone Number
Occupation
Years Known
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