Employment Application
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Chao Restaurants is an equal opportunity employer. Qualified applicants are considered for all positions without regard to race, color,
religion, gender, national origin, age, marital or veteran status, disability or any other protected status.
PERSONAL DATA Date of Application ___________________
Name ___________________________________________ Social Security No. _____________________
Last First Middle Initial
Present Address ________________________________________________________________________________
Number Street City State Zip Code
How long have you lived at this address? _________________ Telephone No. (__________)_________________
Previous Address ________________________________________________________________________________
Number Street City State Zip Code
In Case of Emergency, Contact: __________________________ Telephone No. (__________)_________________
Job Applied For: ______________________________________ Rate of Pay Expected: $_________ per ________
AVAILABILITY: List hours available to work per week
Check here if available anytime When are you available to start? _____________
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
From To From To From To From To From To From To From To
Have you ever worked for Chao Restaurants?
If yes, when? _______________________ Where? _______________________________________
Do you have any relatives or friends currently working for Chao Restaurants?
If yes, state relationship to you and the restaurant location: _________________________________________
Are you able to perform the essential duties and responsibilities of the job for which you’re applying with or without reasonable
accommodation? _______Yes _______No
If you require accommodation to perform the job duties, please describe: (Refer to position description if necessary)
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Are you able to provide verification of your legal right to work in the United States of America? _______ Yes _______ No
(Proof of identity and eligibility will be required upon employment.)
2005 Chao Restaurants LLC
BACKGROUND
Are you old enough to legally serve alcohol (18 years of age)? Yes No
If No, Date of Birth ______/_______/_________
(If under 18 years of age, you may be required to provide authorization to work.)
Have you ever been convicted of a felony? Yes No
Have you ever been convicted of any crime, excluding misdemeanors? Yes No
Have you ever been convicted of any crime involving violence to another person? Yes No
Have you ever been convicted of any crime involving theft or dishonesty? Yes No
Are you currently serving probation for any misdemeanor offense? Yes No
If you have answered “Yes” to any of the above, describe in full:
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EMPLOYMENT HISTORY
List all present and past employers below, starting with most recent. Please indicate if you’re still employed.
Name, Address and Phone From To Position and Brief Description Starting Ending Reason for Name of May We
Number of Duties Salary Salary Leaving Supervisor Contact?
PERSONAL REFERENCES (Not former employers or relatives)
Name and Address Occupation Relationship Phone Number
EDUCATION
School Name and Location Years Attended Diploma/Degree Did you Major/Course of Study
Graduate?
High
School
College/
University
IMPORTANT – READ BEFORE SIGNING
I certify that information given herein is true and complete to the best of my knowledge. I authorize investigation of all statements and
references contained in this employment application as may be necessary in arriving at an employment decision, including requests for criminal,
credit, or motor vehicle driving reports. I understand that incorrect, misleading or incomplete information on this application may result in
immediate termination of employment. I understand that this employment application and any other company documents are not contracts of
employment and that, if employed, my employment is considered “at will” and that the employment relationship may be terminated by either party
at any time, for any reason. I also understand that any oral or written statements to the contrary are expressly disavowed and should not be relied
upon by any prospective or existing employee. I understand that the use of illegal drugs is prohibited during employment. If company policy
requires, I am willing to submit to drug testing to detect the use of illegal drugs during employment.
Forms
Signature_____________________________________________ Date________________________
2005 Chao Restaurants LLC