Rovali’s
Ristorante Italiano - Application for Employment
We consider applicants for all
positions without regard to race, color, religion,
sex, national origin, age, disability, veteran
status or any other legally protected
status.
**
Please fill out form completely **
Position(s)
applied for
How did you find out about
this job?
Newspaper
Employee
Walk-in
Relative
Other
Why are you seeking a
new job at this time?
Applicant
Information
First Name
Middle
Last
Street Address
City/State/Zip
Phone
If hired, do you have
a reliable means of transportation to get
to work?
Describe
Are you at least 18 years
old?
If you are under 18 years
of age, can you furnish a work permit?
If the job you are applying
for requires driving: Driver’s License
No.
State
Expiration Date
Are you legally eligible
for employment in the U.S.?
Have you been convicted
of a crime?
Yes
No
If yes, state the nature
of the offense and disposition of the case.
Include dates and places.
(NOTE: The existence of a criminal record
does not constitute an automatic bar to employment.)
Are you a veteran?
If yes, give dates of
service: From
To
List any special skills
or training:
Employment
Information
Are you seeking full time,
part time or temporary employment?
What hours and shift(s)
would you prefer to work?
List times you are not
available to work?
Are you willing to work
overtime?
Weekends?
Holidays?
Are you currently employed?
If hired, when would you
be able to start?
Have you ever worked for
this organization before?
If yes, name used:
List any friends or relatives
employed by this company:
Have you ever been discharged
or asked to resign from any position?
If yes, please describe:
If applicable, please
refer to the attached job description for
the position for which you are applying. Are
you able to perform all these
tasks with or without reasonable accommodation?
Please describe which tasks, if any, you will
need accommodation to
perform, and explain what type of accommodation
you will need:
Please describe:
Education
Secondary:
9
10
11
12
G.E.D
College:
1
2
3
4
5
6
7
8
Name of School:
Name of School:
Degree & Major:
Location of School:
Location of School:
Minor:
If in high school, are
you enrolled in a recognized co-op program?
Yes
No
If yes, identify program
and school:
Work
History (please begin with most recent)
Company
Phone No. with Area Code
Address
City/State/Zip
Dates of Employment: From
To
Salary: Beginning
Ending
Job Title
Supervisor’s Name
& Title
Describe duties briefly:
Specific reason for leaving:
Company
Phone No. with Area Code
Address
City/State/Zip
Dates of Employment: From
To
Salary: Beginning
Ending
Job Title
Supervisor’s Name
& Title
Describe duties briefly:
Specific reason for leaving:
Company
Phone No. with Area Code
Address
City/State/Zip
Dates of Employment: From
To
Salary: Beginning
Ending
Job Title
Supervisor’s Name
& Title
Describe duties briefly:
Specific reason for leaving:
For references
purposes :Have you worked for any
of these organizations or attended school
under a different name? .
If yes, give name and organization(s)
May we contact
the employers listed above? If not,
list the employers you do not wish us to contact
and why:
Authorizations
& At-Will Employment Agreement
(please read carefully, then
sign and date below)
I certify that I have personally
completed this application. I declare that
the information provided in this employment
application is
true and complete and I understand that any
false information or significant omissions
may disqualify me from further consideration
for employment and may be justification for
my dismissal from employment if discovered
at a later date. I agree to immediately notify
this company if I should be convicted of a
crime while my job application is pending
or during my employment, if hired.
I authorize this company to make an investigation
of all information contained in this employment
application and I release from liability
all companies and corporations supplying such
information. I understand any false answers,
statements, or implications made
by me on this application or other required
documents shall be considered sufficient cause
for denial of employment or discharge.
I specifically authorize and direct my current
and former employers to supply employment-related
information to this company and
do hereby release my current and former employers
from liability for providing information to
this company.
Upon termination of my employment for whatever
reason, I release this company from all liability
for supplying any information
concerning my employment to any potential
employer.
I authorize this company, if applicable, to
request a copy of my credit report, motor
vehicle driving record, and any other investigative
report deemed necessary through various third
party sources. As required by law, upon request
within a reasonable period of
time, I will be notified as to the nature
and scope of such investigations.
I hereby agree to submit to any drug test
required of me, whether prior to my employment
or if employed by this company at any
time thereafter. If requested, I will take
a post-job offer physical examination and
my employment, in the event I receive medical
treatment for any condition, including a physical,
psychological, emotional, or psychiatric condition
that is job-related, I hereby authorize
the limited release and exchange of such medical
information relating to my condition between
the treatment provider and a
company-designated physician.
AT-WILL EMPLOYMENT AGREEMENT
I understand and agree that nothing contained
in this application, or conveyed during any
interview is intended to create an employment
contract between the company and me. In addition,
I understand and agree that if you employ
me, in consideration of my employment,
my employment and compensation will be at-will,
for no definite period of time, and may be
terminated at any time, for
any reason, or for no reason at all. I understand
that only the company’s President is
authorized to change the employment-at-will
status and such a change can only be done
in writing. I have read, understand, and agree
to the above.