Employment

Application for Employment
Exmore Diner
4264 Main Street
P.O. Box 1414
Exmore Virginia 23350
(757) 442-2313

THE APPLICATION MUST BE PLACED IN A SEALED ENVELOPE AND BROUGHT TO THE DINER OR MAILED TO THE ABOVE ADDRESS. APPLICATIONS NOT RECEIVED IN SEALED ENVELOPES WILL NOT BE ACCEPTED. 


PERSONAL INFORMATION

First, Middle, and Last Name______________________________
Street Address___________________________
Mailing Address___________________________
City, State, Zip Code______________________________
Phone Number (___)________________________________
Are you eligible to work in the United States?_________
If you are under age 18, do you have an employment/age certificate?_________
Have you been convicted of or pleaded no contest to a felony within the last 5 years?__________
If so, please explain. ___________________________________________________________________

Are you able to lift 40 pounds? ___________


POSITION AVAILABILITY
Position Applied For______________________________
Days/Hours Available *Must Be Available to Work Mornings, Nights, Weekends, & Holidays* Exmore Diner Hours are Monday through Saturday 6 a.m. until 8 p.m. and Sunday 6 a.m. until 6 p.m. You are expected to stay one-half hour after closing time and arrive 15-30 minutes before your shift starts. Please keep in mind that the more limited your available hours are the less likely you will be considered for the position. 

 What Hours Are You Available on the Following Days?
Monday: From___________________  To__________________
Tuesday: From__________________  To___________________
Wednesday: From________________  To_________________
Thursday: From___________________  To_________________
Friday: From____________________  To___________________
Saturday: From__________________  To____________________
Sunday: From___________________  To____________________
What date are you available to start work? _________________


EDUCATION
Last Level of Education Completed___________________________________________
Skills/Training/Awards___________________________________________________________________________________

EMPLOYMENT HISTORY
Present or Last Position:
Employer______________________________________________________________
Address ____________________________________
Supervisor_________________________
Phone_____________________________l
Position Title________________________________From:_______ To:________
Responsibilities________________________________________________________
Salary_____________________________
Reason for Leaving____________________________
May We Contact Your Present Employer?____________

Previous Employment:
Employer______________________________________________________________
Address _________________________
Supervisor_________________________
Phone_____________________________
Email______________________________
Position Title______________________________
From:_______ To:_______
Responsibilities________________________________________________________
Salary___________________________
Reason for Leaving__________________________

REFERENCES
Name, Title, Address, Phone
___________________________________________________________________________________________________________________________________________________________________________________

I certify that information contained in this application is true and complete.  I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. 

Signature______________________________

Date___________________________

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