Application for Employment Personal Information Name (Last, First, MI) Social Security Number Current Address Current City Current State Current Zip Permanent Address Permanent City Permanent State Permanent Zip Contact Email Contact Phone Referred By Availability EMPLOYMENT DESIRED Position Date You Can Start Salary Desired Desired Location Education High School Name High School Location High School Degree College Name College Location College Degree Other Name Other Location Other Degree WORK EXPERIENCE Have you previously worked for Acme Oyster House? yesno If you answered YES, when did you last work for us and what location? Job 1 Start Date End Date Place of Employment Phone Supervisor Reason for Leaving Job 2 Start Date End Date Place of Employment Phone Supervisor Reason for Leaving Job 3 Start Date End Date Place of Employment Phone Supervisor Reason for Leaving Job 4 Start Date End Date Place of Employment Phone Supervisor Reason for Leaving Are you at least 18 years old? YesNo I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal at any time. Furthermore, if employed and in consideration for my employment, I agree to conform to the rules and regulations of the company. My employment may be terminated with or without cause and with or without notice at anytime at the option of either the company or myself. I acknowledge that I am an at-will employee. I understand that no management representative has any authority to enter into an agreement of employment for any specified period or to make any agreement or contract with me except for the owner. Any agreement between the owner and myself must be in writing. SPAM Control What color is the sky? AGREEMENT: By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.