Apply Step 1 of 3 33% Name* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How long have you lived at the above address? PhoneAre you 18 years old or older? Yes No If not, state date of birth: MM slash DD slash YYYY If under age 18, how many hours per week are you employed elsewhere? Have you had any name changes this employer should know about in order to verify your job or education history? Yes No Previous Name First Last Do you have transportation to and from work? Yes No Are you authorized to work in the U.S.? Yes No Position Applied ForSushi Chef / Assistant ManagerDate you can start? MM slash DD slash YYYY Salary desired: Are you applying for: Full Time Part Time Temporary Days Only Nights Only Days/Nights Did someone recommend you for this position? If yes, who? Education Please complete all sections that apply to you.High SchoolName and Address of SchoolGrade Completed Did you graduate? Yes No College or UniversityName and Address of SchoolDegree Completed Others (Please specify)Name and Address of SchoolGrade or Degree Completed Did you graduate? Yes No Military ServiceMilitary Schools CompletedAre you a war veteran? Yes No Branch Served From (Date) MM slash DD slash YYYY Served To (Date) MM slash DD slash YYYY Highest Grade or Rank Previous Restaurant Experience Please list your last four employers, starting with the most recent one first.Please check the kind of work you have done: Bartender Bookkeeper Bus Person Carver Chef Cook Cook Helper Counter Dietitian Dishwasher Food Prep Technician Fountain Host or Hostess Kitchen Helper Manager Pantry Pastry Cook Porter Pot Washer Salad Sandwiches Stenographer Typist Vegetable Cook Wait Staff Wait Staff-Arm Service Wait Staff-Tray Service Cashier Drive-thru Previous Employment 1Company Name, Address, and PhoneCompany Business Immediate Supervisor Your Position Title Job Duties Date Started MM slash DD slash YYYY Date Left MM slash DD slash YYYY Beginning Salary Ending Salary Reason for Leaving Previous Employment 2Company Name, Address, and PhoneCompany Business Immediate Supervisor Your Position Title Job Duties Date Started MM slash DD slash YYYY Date Left MM slash DD slash YYYY Beginning Salary Ending Salary Reason for Leaving Previous Employment 3Company Name, Address, and PhoneCompany Business Immediate Supervisor Your Position Title Job Duties Date Started MM slash DD slash YYYY Date Left MM slash DD slash YYYY Beginning Salary Ending Salary Reason for Leaving Previous Employment 4Company Name, Address, and PhoneCompany Business Immediate Supervisor Your Position Title Job Duties Date Started MM slash DD slash YYYY Date Left MM slash DD slash YYYY Beginning Salary Ending Salary Reason for Leaving Job DutiesAre there any job duties that you would be unable to perform?Have you ever applied to this company before? Yes No If yes, where and when did you apply? Are you employed now? Yes No If yes, what is your employer's phone number?Please provide the name, address, phone, and relationship of a person to notify in case of emergency:1. I authorize investigation of all statements contained in this application.* Yes No 2. I understand that misrepresentation or omission of facts called for is cause for dismissal and that my employment is substantially dependent on truthful answers to the forgoing inquiries.* Yes No 3. I have read these statements and answers to these inquiries.* Yes No Today's Date* MM slash DD slash YYYY
