First Name (required) Last Name (required) Date of Birth (required) Phone (required) E-mail Address (required) Permanent Address (required) City (required) State (required) ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming--NOT IN US-- Zip Code Driver License No. and Exp. Date: Employment Desired In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire. Desired Start Date: Although we cannot guarantee a position will be available at any particular location, please select your preferred locations from the drop-down lists in order of preference. First Preference No Preference7000 W. Charleston4811 S. RainbowMeadows Mall2490 E. Desert Inn1292 S. Nellis7280 W. Azure Second Preference No Preference7000 W. Charleston4811 S. RainbowMeadows Mall2490 E. Desert Inn1292 S. Nellis7280 W. Azure Third Preference No Preference7000 W. Charleston4811 S. RainbowMeadows Mall2490 E. Desert Inn1292 S. Nellis7280 W. Azure How did you hear about us? Languages that you are able to speak, read and write: Are you currently employed? YESNO Have you ever worked for Frijoles & Frescas? Please explain how employment ended. Do you know any employees of Frijoles & Frescas? If so, whom do you know? Shift or Hours preferred: DayNightAny Available Shift Are you looking for part-time or full-time employment? Part-timeFull-timeAny Available Opening Other time How are you able to get to work? What restaurant experience do you have? Do you have any limitations that would keep you from being able to work in a restaurant? YESNO Previous Employment From To Employer Name and/or Address Last position Reason for leaving From To Employer Name and/or Address Last position Reason for leaving From To Employer Name and/or Address Last position Reason for leaving Please indicate years of education completed High School College Business or Trade School Other (specify) Personal Reference Please list one non-relative whom you have known for at least two years Name and Address Business Telephone Number Years known Emergency Contact Name and Address Relationship Telephone Number Years known I certify all statements to be true and correct and authorize the investigation of all statements contained in this application. I understand that misrepresentations or omissions of facts from this application is cause for dismissal.