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APPLICATION FOR EMPLOYMENT
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Name *
Last, First, M.I.
Address *
Street Address, City, ST, Zip
Email *
Home Phone Number *
Cell Phone Number *
Are you legally authorized to work in the U.S.? *
If hired, verification will be required by law. 
Are you of legal age to serve alcoholic beverages? *
Have you ever worked for Marugame Udon? If yes, select "other" and enter when.  *
Do you know anyone employed with Marugame Udon? If yes, please select "other" and list their name(s).  *
Have you ever been convicted of a felony? If yes, please select "other" and explain.  *
Which position(s) are you interested in? *
Required
Expected Starting Hourly Rate *
Date available to start work *
MM
/
DD
/
YYYY
Hours Available
M
T
W
Th
F
Sat
Sun
Before 3pm
After 3pm
How many hours per week do you want to work? *
Enter range (ex. 20-32 hours)
Education
High School
Please note name, address of school, dates of attendance, did you graduate?
College School
Please note name, address of school, dates of attendance, degree/major, did you graduate? 
Employment History
Please list three most recent employers, beginning with the most recent one. 
Employer #1
  • Company
  • Address
  • Job Title
  • Duties Performed
  • Dates of employment
  • Reason for leaving
  • Supervisor
  • Phone No. 
Employer #2
  • Company
  • Address
  • Job Title
  • Duties Performed
  • Dates of employment
  • Reason for leaving
  • Supervisor
  • Phone No. 
Employer #3
  • Company
  • Address
  • Job Title
  • Duties Performed
  • Dates of employment
  • Reason for leaving
  • Supervisor
  • Phone No. 
Personal References (3)
Not relatives or significant others.
Name / Relationship / Phone No.
Name / Relationship / Phone No.
Name / Relationship / Phone No.
Job Skills and Qualifications
Summarize any special training, skills, licenses, and/or certifications that may assist you in performing the position for which you are applying.

I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for dismissal in accordance with company policy. I authorize the references and supervisors listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you, for any reason without any further liability.  I agree that all of the consents, authorizations and releases which I have made in this document shall be irrevocable during the period of my employment should I be hired by the Company.  In consideration of employment, I agree to conform to the rules and regulations of the company and my employment and compensation can be terminated at any time, at the option of either the company or myself.  I authorize and understand that my employment will be conditioned on the completion of a satisfactory background check, including criminal offenses, and may include passing a test for illegal drug use. 

Type your name and date to confirm yes.  *
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