PERSONAL

Position(s) Applied For:

Name:

Email Address:

SSN #:

Type of Employment Desired:

Full TimePart TimeTemporarySeasonal Internship

Date of Application:

Address:

Phone #:

Date Available to Work:

Have you applied/interviewed with Tropix Pots Cuisines Bar & Grill in the last 6 months?

YesNo

Do you have a checking or savings account into which Tropix Pots Cuisines Bar & Grill LLC can direct deposit your pay?

YesNo

EMPLOYMENT HISTORY

PROVIDE THE FOLLOWING INFORMATION FOR YOUR PAST 3 EMPLOYERS, ASSIGNMENTS, OR VOLUNTEER ACTIVITIES, STARTING WITH THE MOST RECENT:

From:

To:

Phone:

Address (SUMMARIZE THE NATURE OF THE WORK AND RESPONSIBILITIES):

Employer:

Job Title (IMMEDIATE SUPERVISOR AND TITLE):

Reason For Leaving:

Salary

EMPLOYMENT HISTORY CONTINUED

From:

To:

Phone:

Address (SUMMARIZE THE NATURE OF THE WORK AND RESPONSIBILITIES):

Employer:

Job Title (IMMEDIATE SUPERVISOR AND TITLE):

Reason For Leaving:

Salary

EDUCATIONAL BACKGROUND

NAME AND LOCATION :

High School

College/University

Other

Did You Graduate ?

Yes No

Special Skills

YEARS COMPLETED :

High School

College/University

Other

COURSE OF STUDY :

High School

College/University

A VOCATIONAL INTERESTS OR HOBBIES:

ACKNOWLEDGEMENT AND AUTHORIZATION

I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer's service, whenever it is discovered.

I give the employer the right to contact and obtain information from all references, employers, educational institutions, and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.

If I am hired, I understand that I am free to resign at any time with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute a contract for employment for any specified period. I understand that no representative of the employer, other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.

I understand it is this company's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA.

I understand that if I am hired, I will be required to provide proof of identity and legal work authorization.

REFERRAL SOURCE: HOW DID YOU HEAR ABOUT THIS POSITION?

Please prove you are human by selecting the tree.

TROPIX POTS CUISINE BAR & GRILL APPLICATION FORM

PERSONAL

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY CONTINUED

EDUCATIONAL BACKGROUND

ACKNOWLEDGEMENT AND AUTHORIZATION