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EAST BAY DELI Employment Application OFFICE USE ONLY Hire Date Rate of Pay Birthday Deli APPLICANT INFORMATION Name Last Name First Date Street Address Apartment/Unit City State Phone E-mail Address Date Available ZIP Social Security No. Desired Salary Position Applied for Are you a citizen of the United States YES NO If no are you authorized to work in the U.S. Have you ever worked for this company If so when Have you ever been convicted of a felony If yes explain AVAILABILITY Sunday Monday Tuesday Wednesday Thursday Friday Saturday EDUCATION Name and Location Years Attended Did you Graduate Subjects Studied High School College Other REFERENCES Please list three professional references. Full Name Address phone Relationship Years Known PREVIOUS EMPLOYMENT Company Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference MILITARY SERVICE Branch Rank at Discharge Type of Discharge If other than honorable explain DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment I understand that false or misleading information in my application or interview may result in my release. Full Name Address phone Relationship Years Known PREVIOUS EMPLOYMENT Company Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference MILITARY SERVICE Branch Rank at Discharge Type of Discharge If other than honorable explain DISCLAIMER AND SIGNATURE I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment I understand that false or misleading information in my application or interview may result in my release.

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