<p>The Haven Restaurant Employment Application</p><p>Applicant Information</p><p>Full Name: Date: Last First M.I.</p><p>Address: Street Address Apartment/Unit #</p><p>City State ZIP Code</p><p>Phone Number: Email</p><p>*We will call if we want to schedule an interview. Please be sure to pick up your messages.</p><p>Date Available: Desired Wage:$</p><p>Position Applied for:</p><p>YES NO Are you 18 years of age or older? If no, age? YES NO Do you know anyone that has worked here Who?</p><p>YES NO Are you your own source of transportation?</p><p>YES NO Have you ever been convicted of a felony?</p><p>If yes, explain:</p><p>Education Average G r a d e s School: :</p><p>YES NO From: To: Did you graduate? Diploma::</p><p>High Average School: G r a d e s</p><p>1 :</p><p>YES NO From: To: Did you graduate? Diploma:</p><p>Average G r a d e s College: :</p><p>YES NO From: To: Did you graduate? Degree:</p><p>Previous Employment</p><p>Job Title: Starting Wage:$ Ending Wage:$</p><p>Responsibilities:</p><p>From: To: Reason for Leaving:</p><p>YES NO May we contact your previous supervisor for a reference?</p><p>Company: Phone: Address: Supervisor:</p><p>Job Title: Starting Wage:$ Ending Wage:$</p><p>Responsibilities:</p><p>From: To: Reason for Leaving:</p><p>YES NO May we contact your previous supervisor for a reference?</p><p>Company: Phone: Address: Supervisor:</p><p>Job Title: Starting Wage:$ Ending Wage:$</p><p>Responsibilities:</p><p>From: To: Reason for Leaving:</p><p>YES NO May we contact your previous supervisor for a reference?</p><p>2 Availability April – Mid June</p><p>Monday- What timeframes are you available? From: To:</p><p>Tuesday What timeframes are you available? From: To:</p><p>Wed. What timeframes are you available? From: To:</p><p>Thursday What timeframes are you available? From: To:</p><p>Friday What timeframes are you available? From: To:</p><p>Saturday What timeframes are you available? From: To:</p><p>Sunday What timeframes are you available? From: To:</p><p>Any vacations? Dates:</p><p>Availability Mid June – September</p><p>Monday- What timeframes are you available? From: To:</p><p>Tuesday What timeframes are you available? From: To:</p><p>Wed. What timeframes are you available? From: To:</p><p>Thursday What timeframes are you available? From: To:</p><p>Friday What timeframes are you available? From: To:</p><p>Saturday What timeframes are you available? From: To:</p><p>Sunday What timeframes are you available? From: To:</p><p>Any planned vacations? Dates:</p><p>General Questions</p><p>Why would you like to work for The Haven:</p><p>Special Skills/ Accomplishments</p><p>Any after school activities?</p><p>Hobbies/Interests</p><p>How many hours per week would you like to work?</p><p>3 Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Your signature will be taken during the interview, should you be selected for one. For now, just type in your name and the date.</p><p>Signature: Date:</p><p>You can email this application to [email protected] Or You can print, and drop off at our sister company, The Pondside Motel, right next door to The Haven. Place in the US Mail Slot, which inside the Hall Entrance door.</p><p>4</p>