Dillons Employment Application

Employment Application

Dillons Restaurant and Sports Bar

Application Data

How were you referred to us?

Today's Date

Date

What position are you applying for?

Full Name

Phone Number

Address

City

State

Zip Code

Email Address

Date Available

Date

Salary Requirements

If you are under 18 years of age, can you provide a work permit?

YesNo

If No, please explain?

Have you ever worked for Dillons?

YesNo

If Yes, when?

Are you a citizen of the United States?

YesNo

If not, are you legally allowed to work in the United States?

YesNo

Type of employment desired

Full TimePart TimeTemporarySeasonal

Have you ever been arrested, pleaded guilty, no contest, or convicted of a crime?

YesNo

If Yes, give dates and details

(Note: Dillons requires background checks on all applicants. Answering Yes to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness, and nature of the violation, rehabilitation, and position applied for will be considered

Summarize Your Special Skills or Qualifications

High School Attended

College Attended

Graduated?

YesNo

Major

Any other special trade/education received?

Availability - List hours you are available to work weekly.

Monday through Sunday

How many hours a week would you like to work?

Rate Yourself! 1=Improvement Needed 2=Ok 3=Good 4=Top Performer

Energy Level - your sense of urgency, self motivation and enthusiasm

Communication Skills - your ability to listen well and express yourself

Social - your natural friendliness and customer service orientation

Reliability - dependability, attendance, dedication and self disipline

Personal Pride - your appearance and sense of achievement

Teamwork - your cooperation with others and team spirit

1. What achievement in life are you most proud of?

2. What are your personal strengths?

3. What are your weakest areas?

4. Why do you want to work at Dillons?

5. Do you have reliable transportation?

6. Is there anything that would prevent you from carrying out the duties you are applying for?

Previous Employment History (begin with your most recent position)

Employment Dates From

Employment Dates To

Position Held

Company Name

Address

City

State

Zip

Phone

Supervisor

Title

Responsibilities

Starting Salary

Ending Salary

Reason for Leaving

May we contact this employer?

YesNo

Employment Dates From

Employment Dates To

Position Held

Company Name

Address

City

State

Zip

Phone

Supervisor

Title

Responsibilities

Starting Salary

Ending Salary

Reason for Leaving

May we contact this employer?

YesNo

Employment Dates From

Employment Dates To

Position Held

Company Name

Address

City

State

Zip

Phone

Supervisor

Title

Responsibilities

Starting Salary

Ending Salary

Reason for Leaving

May we contact this employer?

YesNo

I certify that the answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal employment, educational, financial, and other related matters as it may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquires in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

Signature of Applicant

Date

Background Consent Form

It is our policy to perform applicant and resident background checks in connection with applications for rental. In performing the background checks, we may request a "consumer report" to learn information about you that may be used in making a rental decision. A consumer report is a report obtained from a consumer reporting agency that may include, but is not limited to, your criminal history which may be on file in any federal, state, or local agency.

If any adverse action is made in regard to your application for rental based entirely or in part on the information contained in a consumer report, you will be notified of that decision. Signature on this form entitles Dillons Restaurant and Sports Bar to receive any consumer report. Your signature indicates that you have carefully read and understand this procedure and consent to the release of a consumer report or an investigative consumer report to Dillons Restaurant and Sports Bar for employment purposes.

Name

Present Address

Street Address

Street Address Line 2

City / State

Birth Date

MonthDayYear

Social Security No.

Applicant Signature