Cantina Restaurant Application Form

Application for Hourly Employment

651 E. Blithedale Mill Valley, CA 94941
Today's Date

MonthDayYear
Date
Full Name*

First NameMiddle InitialLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Position Desired
Choose
Available start date:*

MonthDayYear

Availability, Check the shifts you are available

	Lunch	Dinner	Mid
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Have you ever been employed by this company before?

Applied1Employed 2
Are you related to or acquainted with any present or former employee?
If yes, list name(s) and relationship
Are you authorized to work and remain in the United States?

YesNo
Have you ever been convicted of any violation of the law? (Exclude traffic violations) A conviction will not necessarily disqualify an applicant from the position sought.

YesNo
If Yes, Explain:
Position Apply For
Education:
Are you presently attending school?

YesNo
High School?

YesNo
Name of High School
Address of High School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you graduate?
College?

YesNo
Name of College
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you graduate?
Employment History

Beginning with your present or most recent experience, account for all employment during the past ten (10) years. To elaborate, asupplemental sheet or resume may be attached, but cannot be substituted for a completed application. Include military service ifapplicable.
Name of Employer:
Job Title:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Supervisor:
Date started

MonthDayYear
Date ended

MonthDayYear
Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

YesNo
Name of Employer:
Job Title:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Supervisor:
Date started

MonthDayYear
Date ended

MonthDayYear
Reason for Leaving:
Description of Duties:
Inquiry may be made of your current and former employers/schools you attended.
May we contact your present employer?

YesNo
May we contact your former employers?

YesNo
Personal References
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business or Occupation
Phone Number

Area CodePhone Number
Full Name #2

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business or Occupation
Phone Number

Area CodePhone Number
Upload Resume (optional)

Upload a File

Cancelof
Why do you want to work at The Cantina?
By submitting this electronic application, I herby authorize investigation of all statements contained in this application and certify that such are true and understand thatif I am hired any misrepresentation on this application is just cause for termination.
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Application for Hourly Employment

Education:

Employment History

Personal References