Teriyaki Planet West Greeley
6628 W 10th Street, STE 103
Greeley, CO
80634
Application For Employment
Applicant Information
Last Name
First Name
M.I.
Street Address
Unit #
City
State
Zip
Phone
Email
Date Availible
Desired Pay Rate
Are you a U.S. citizen?
Yes
No
If No, are you authorized to work in the U.S.?
Yes
No
Have you ever been convicted of a crime?
Yes
No
If yes, explain
ALL QUESTIONS MUST BE ANSWERD!
Education
High School
City & State
From
To
Did you Graduate?
Yes
No
College
City & State
Degree
From
To
Did you Graduate?
Yes
No
Other
City & State
Focus
From
To
Did you Graduate?
Yes
No
References
Reference 1
Full Name
Relationship
Phone
Company
Address
Reference 2
Full Name
Relationship
Phone
Company
Address
Reference 3
Full Name
Relationship
Phone
Company
Address
Previous Employment
Employer 1
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
Note (optional)
Employer 2
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
Note (optional)
Employer 3
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
Note (optional)
Why do you want to work for us?
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.
Please Verify You Are Human :-)
Thank you!
Signature (Please Type You Name)
Date
Note: If you would like to include a resume and cover letter please email them to
teriyakiplanet3@gmail.com
. A resume will not substitute for filling out this application.