First Name: Last Name: Date of Birth: (mm/dd/yyyy)
Mailing Address: City: State: Zip Code: Phone: Cell Phone: E-mail:
Are you a U.S. Citizen?
Yes No
If checked no, do you have a legal right to work in the U.S.? Yes No
Have you ever been convicted of a crime other than a misdemeanor or traffic infraction?
Note: Conviction is not an automatic bar to employment. Each case will be considered on its own merits.
APPLYING POSITION
Waiter Waitress Host/ess Busser
Other (Please describe below)
PREFERENCE
Which location are you applying for? Sacramento, CA Woodland, CA Miyagi Bar & Sushi
What is your applying preference? Full-time Part-time Seasonal
How long do you plan on working with us? Less than 6 months 1 year More than 1 year
Please specify your availability for work. (Times are approximated, does not imply that you work all shifts checked)
Lunch Shift Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Dinner Shift Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Date you can begin working: January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
EDUCATION
Please list most recent first.
WORK EXPERIENCE OR REFERENCES
Please list your present or most recent experience or reference first.
Employer/Reference Telephone
From (Month/Year) To (Month/Year)
Address (Number/Street/City/State/Zip)
Supervisor May we contact for reference? Yes No
Reason for Leaving
Description of Duties
I hereby certify that the information contained in this form is true and correct. I authorize Osaka Sushi to contact any of my schools, employers or other references checked yes for the purpose of collecting and obtaining an account of my work experience. I agree to hold any or all them blameless and free of liability for releasing any such information. I understand that if I am employed, any deletion, misrepresentation or misstatement of the facts as stated or implied may result in my dismissal. I understand that this application does not bind either myself or the employer for any specific period regarding employment, and that no promise to the contrary can be made by another employee of Osaka Sushi Japanese Restaurant.
Osaka Sushi considers applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job related medical condition or disability, or any other legally protected status.