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- Employment

Be a valuable team member at Randy's Family Restaurant. Where Faith, Family, and Friends matter most!

Personal Information

First Name

Last Name

MI

Phone

Date of Birth

Current Age

Address

Email

Do You Have A Criminal Record?
YesNo

If Yes Explain?

Did Someone Refer You? If So Who?

Please Provide an Emergency Contact

Name

Phone

Relationship

Job Information

Position Applying For
Wait StaffHost/HostessCookDishwasherCleaner

What is Your Desired Rate of Pay?

Type of Employment
Full TimePart TimeAny

What Date Are You Available to Start

Education

Have You Graduated High School?
YesNo

Are You In College?
YesNo

Years Left?

Employment History

Is This Your First Job?
YesNo

Starting with your most recent employer, provide the following information.

Employer

Dates Employed:

Job Title

Phone

May We Contact?
YesNo

Why Did You Leave This Job?

Employer

Dates Employed:

Job Title

Phone

May We Contact?
YesNo

Why Did You Leave This Job?

Employer

Dates Employed:

Job Title

Phone

May We Contact?
YesNo

Why Did You Leave This Job?

Employer

Dates Employed:

Job Title

Phone

May We Contact?
YesNo

Why Did You Leave This Job?

Other Information

Have You Ever Been Fired From a Job?
YesNo

Have You Ever Worked in A Restaurant Before?
YesNo

Are You Currently Employed?
YesNo

Will Randy's Be Your Only Job?
YesNo

If No, Will Randy's Be Your Primary or Secondary Job?

Why Do You Think Randy's Should Hire You?

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct.
Yes

I expressly authorize Randy’s Family Restaurant to contact and obtain information from all references (personal and professional) to otherwise verify the accuracy of all information provided by me in this application, résumé, or job interview.
Yes

Signature of Applicant

Date Signed

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