Your Name (required)

Your Email (required)

Subject


Date Available for Employment (Format: 2016-01-01):

Location Applying For (Check applicable):
 Any Location Kailua Ward Waipio Windward Mall Kaimuki Pearlridge Corporate Other


Position Applying For (Check applicable):
 Corporate Management Human Resources Accounting Sales Marketing District/Area Management General Manager Restaurant Manager (Asst. Manager) Kitchen Manager/Chef Asst. Kitchen Manager/Sous Ched Server Server Asst. (Host/Bus/Expediter) Bartender Banquets & Catering Line Cook Prep Cook Pantry Dishwasher Banquet Cook


What led you to employment at Big City Diner?

How did you hear about employment opportunities?

Have you ever been employed at Big City Diner in the past?
 Yes No
If so, please specify dates of employment (Format: 2016-01-01):

At what location:

Who was your supervisor:

GENERAL INFORMATION:

Last Name:

First Name:

MI:

Physical Address:

Home Phone:

City:

State:

Zip Code:

Cell Phone:

Permanent Mailing Address:

Other Phone:

City:

State:

Zip Code:

Email:

If hired, can you provide proof of eligibility to work in the United States?
 Yes No

AVAILABILITY TIMES:

Mon - From/To:

Tuesday - From/To:

Wednesday - From/To:

Thursday - From/To:

Friday - From/To:

Saturday - From/To:

Sunday - From/To:

Total Hours Available For Work Per Week? (Actual hours are at the discretion of Big City Diner):

Are you seeking seasonal employment?
 Yes No
Apart from religious observances, are you available to work all days, including weekends and holidays?
 Yes No
Will you be off island anytime within the year?
 Yes No

Applicants Initial:

EMPLOYMENT HISTORY:

THIS SECTION MUST BE COMPLETED even though you attach a resume. START with your most RECENT employer and list all previous employers. Include self-employment, military service, summer and part-time jobs. Please account for employment of the past 10 years or at least your last three jobs. If you have worked under another name or alias, please specify. DO NOT PUT “SEE RESUME”, though you may attach one.


Employer Name:

Dates Employed (Format: 2016-01-01):

Address:

City/State/Zip:

Average Hours Worked Per Week:

Start (Format: 2016-01-01):

End (Format: 2016-01-01):

Supervisor Name & Title:

Phone(Please specify area code):

Pay Rate:

Start:

End:

Positions & Duties:

Reason For Leaving:



Employer Name:

Dates Employed (Format: 2016-01-01):

Address:

City/State/Zip:

Average Hours Worked Per Week:

Start (Format: 2016-01-01):

End (Format: 2016-01-01):

Supervisor Name & Title:

Phone(Please specify area code):

Pay Rate:

Start:

End:

Positions & Duties:

Reason For Leaving:



Employer Name:

Dates Employed (Format: 2016-01-01):

Address:

City/State/Zip:

Average Hours Worked Per Week:

Start (Format: 2016-01-01):

End (Format: 2016-01-01):

Supervisor Name & Title:

Phone(Please specify area code):

Pay Rate:

Start:

End:

Positions & Duties:

Reason For Leaving:



ACKNOWLEDGEMENT: With my initials affixed here, I hereby authorize and grant Big City Diner and their representatives to contact my present employer.

APPLICANTS INITIALS:

EDUCATION:

High School Name & Location:

No. of Years:

GED:
 Yes No
GPA:




College/University Name & Location:

No. of Years:

Other:

GPA:




Technical School Name & Location:

No. of Years:

Other:

GPA:

Any other school, courses, seminars or special training that you would like for us to consider:

PERSONAL REFERENCES:

Please list at least (3) three personal references. DO NOT list any relatives or anyone that resides in the same household.

Full Name:

Occupation:

Years Known:

Address:

Phone:




Full Name:

Occupation:

Years Known:

Address:

Phone:




Full Name:

Occupation:

Years Known:

Address:

Phone:

MISCELLANEOUS:

Do you know anyone currently employed by Big City Diner?
 Yes No
If yes, what is their name? What location do they work?

Are you able to perform the essential functions of the position for which you are applying with, or without reasonable accommodation?
 Yes No
If employed, do you agree to abide and adhere to all Big City Diner policies, practices and procedures including ALL SAFETY rules?
 Yes No
Are you willing to provide a CLEAN and valid Driver Abstract upon being hired?  Yes No

APPLICANT NOTICES, ACKNOWLEDGEMENTS AND SIGNATURE:

Please read the following paragraphs and statements carefully ensuring that you understand them BEFORE you affix your signature to this application.

TRAINING AND SAFETY REQUIREMENT

I understand that Big City Diner- ETAL is committed to providing all employees and guests with a positive and safe working environment. Though there is never a guarantee that no accidents will occur, Big City Diner makes safety a priority and it is ultimately the responsibility of each employee and individual to protect their safety and personal welfare. Therefore, I understand that if offered employment with Big City Diner I will be REQUIRED to be available during all shifts and for MANDATORY training classes, orientations and meetings throughout the course of employment.

I further understand that if offered a position, I will be available during all shifts and hours for at least the first (2) two weeks to (30) thirty-days as required for the position, if hired. I understand that this is regardless of any availability I may have included on this application or elsewhere. I understand that it will be my responsibility to make the necessary arrangements.

Applicant Initials:

DRUG & ALCOHOL FREE WORKPLACE

I understand that Big City Diner promotes and is committed to a drug-free workplace. Further, I understand that because of this commitment, Big City Diner does utilize a drug & alcohol-testing program. If I am extended an offer of employment with Big City Diner, I understand that I may be required to submit to and pass a drug and/or alcohol test for the abuse of illegal substances prior to being hired. It is also understood and agreed that once hired as a condition of employment with the company, employees are required to undergo further drug testing through its Drug Free Workplace Policy including but not limited to: periodic, reasonable cause, post accident and random. Any employee who refuses to submit to such test and/or to authorize the release of test results are considered to have tested “positive” and shall be subject to disciplinary action, including immediate termination.

Applicant Initials:

EQUAL EMPLOYMENT OPPORTUNITY

I understand that in accordance with applicable laws governing Equal Employment Opportunity, Big City Diner prohibits the discrimination of any applicant, employee, vendor or customer. For this reason, discrimination against anyone based on his or her race, color, religion, sex, age, national origin, disability, veteran or other protected status, as defined by law is strictly prohibited

Applicant Initials:

IMMIGRATION CONTROL AND REFORM ACT OF 1986

I understand that Big City Diner is required to comply with the Immigration Control and Reform Act of 1986 (“ICRA”) and to verify and employ only those individuals that are legally authorized to work in the United States. The employee, regardless of national origin, must present original documents to verify employment eligibility and complete the Employee Section of the required Form I-9 as governed by Federal Law. It is further understood and agreed that any employee who does not demonstrate their compliance with ICRA, will be subject to immediate termination.

Applicant Initials:

BACKGROUND AND CREDIT CHECK

I certify that to the best of my knowledge that the statements made by me in this application are true and correct without omission of any kind. I further understand that any false information I give when applying for employment, whether in this application or otherwise, may result in disciplinary action including termination of employment regardless of when discovered. I hereby, give authorization to Big City Diner, its managers, employees and vendors to conduct a background, employment, reference, credit check and/or investigation, along with an investigation of my statements made in this application or throughout the course of employment if hired, except for any information about disability and medical conditions or treatment, which is protected under the Americans with Disabilities Act. I understand that all information obtained will be held in confidence to the most reasonable extent possible. I understand that in conducting checks and investigations now and through the course of employment if hired, it may be required that Big City Diner provide the information contained on this application to outside vendors for the completion of such checks and investigations.

Applicant Initials:

EMPLOYMENT AT-WILL

I understand and agree that no question or statement contained within this application is intended or is to be construed as an offer of
employment nor is it a Contract or Agreement of Employment. I understand that any all Contracts or Agreements of Employment must be in
writing and signed by both the President and Owner and the Director of Human Resources. I further understand and agree that if employed by Big City Diner, that my employment relationship is “AT-WILL” and can be terminated at any time either by myself or the Company, with or without cause or reason and with or without notice.

Applicant Initials:

ACKNOWLEDGEMENT AND SIGNATURE

I, certify that the information provided by me on this application is true and correct to the best of my knowledge. Further, I understand and agree that I have read and understand the statements acknowledged.

Applicant Signature (Type Full Name):

Date (Format: 2016-01-01):