Employment Application

Position of Interest

In detail please explain exactly how you see yourself helping us to serve our guests:

Full Name

First NameLast Name

Present Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail

Phone Number

Area CodePhone Number

Are you employed now?

If yes, may we inquire of your present employer?

Are you legally authorized to work in the U.S.?

Have you ever applied to this company before?

If yes, when?

If yes, please explain:

Are you allergic to cats or dogs?

Are you over 18 years old?

Do you have reliable transportation?

Salary Desired:

Can you work any shift?

If no, please explain:

Can you work weekends?

Can you work holidays?

Are you able to perform the essential functions of the job for which you are applying with or without a reasonable accomodation?

How many words can you type per minute?

MonthDayYear

When can you start?

MonthDayYear

High School

Name and Location

Dates Attended

Did you graduate?

College

Name and Location

Years Attended

Did you graduate?

Subjects Studied

Trade, Business, or Correspondence School

Name and Location

Years Attended

Did you graduate?

Subjects Studied

Full Name:

Relationship

Phone Number

Area CodePhone Number

Full Name:

Relationship

Phone Number

Area CodePhone Number

Special Training or Skills

How many words can you type per minute?

Name & Address

Name and Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Started

MonthDayYear

Ended

MonthDayYear

Position:

Responsibilities:

Reason for Leaving:

Name & Address

Name and Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Started

MonthDayYear

Ended

MonthDayYear

Position:

Responsibilities:

Reason for Leaving:

Name & Address

Name and Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Started

MonthDayYear

Ended

MonthDayYear

Position:

Responsibilities:

Reason for Leaving:

What are my goals for this position:

Cha Cha's may request from a consumer reporting agency and for employment-related purposes, a "consumer report" (background report) containing background information about you in connection with your employment, or application for employment, or engagement for services. Checking this box authorized Cha Cha's to obtain the consumer reports described above about me

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.
_____

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.
_____

I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
_____

I agree with the above statement:

Apply for a Position

Please describe in detail why you are a great candidate for this position?

Education History

Professional References

General Information

Former Employers (most recent first)

Authorization