GENERAL INFORMATION

Please complete all requested information.

Today’s Date

Position Applying For

Name(Last)              (First)                (Middle)

Minimum Salary Desired

Date Available for Work

Street Address

Are you at least 18 years old? Yes No

City                                  State                          Zip

Telephone (Home)                        Telephone (Work)

() -              () -

Have you ever used any other name(s) which is (are) necessary for us to know in order for us to verify your employment or educational record?
Yes No

Are you available to work overtime as needed?

Yes No

If yes, are you available weekdays? Yes No
weekends? Yes No

PERMISSION TO WORK

Are you legally authorized to work in the United States? Yes No

Will you now or in the future require sponsorship for employment visa status (e.g. H-1B status)?
Yes No

WORK EXPERIECE

Please specify your complete full-time and part-time employment history, including self-employment. You may include any verified work performed on a volunteer basis. Begin with your most recent employer.

Company Name

Telephone

() -

Address

Employed (Month and Year)

FromTo

1

Name, Title, and Phone Number of Supervisor

Job Title and Work Responsibilities

Reason for Leaving:

Company Name

Telephone

() -

Address

Employed (Month and Year)

FromTo

2

Name, Title, and Phone Number of Supervisor

Job Title and Work Responsibilities

Reason for Leaving:

Company Name

Telephone

() -

Address

Employed (Month and Year)

FromTo

3

Name, Title, and Phone Number of Supervisor

Job Title and Work Responsibilities

Reason for Leaving:

EDUCATION & TRAINNG

School

Name and Location of School

Number of Years Completed

Degree

Type of Course/Major

College

High School

JOB-RELATED SKILLS AND QUALIFICATIONS

Please summarize your job-related skills and qualifications:

Emergency Contact Person

Name: Phone Number:

APPLICANT’S STATEMENT ACKNOWLEDGMENT

THIS APPLICATION IS NOT COMPLETE UNTIL IT IS FULLY COMPLETED, SIGNED, AND

ALL STATEMENTS BELOW HAVE BEEN READ AND .

Initial: I certify that all of the information furnished on this application and during the application process is true, complete and correct to the best of my knowledge. I understand that any misrepresentation or omission of facts called for may result in refusal to hire or, if hired, may result in my dismissal at any time regardless of when the false answer or omissions are discovered.

Initial: I recognize that this employment application is not an offer of employment. I agree that if I am hired by the Company, I will be an at-will employee, meaning that either the Company or I may end the employment relationship at any time with or without cause or notice. I understand that only the Managing Partner, Executive Chef or General Manager of HotB, and no floor manager, supervisor, or other representative of the Company, has authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the at-will employment relationship, and with respect to any agreement entered into by the Managing Partner, Executive Chef or General Manager , any such agreements must be in writing and signed by the Managing Partner, Executive Chef or General Manager and by me or my authorized representative.

Initial: I further understand and agree that, except for my at-will employment status, if hired, my wages, hours, working conditions, job assignment(s), and compensation rate(s) will be subject to change by HotB.

Initial: I understand that the Company may share the information contained in this application with other Company employees for employment and administrative purposes and hereby consent to such transfer.

Initial: I hereby authorize, to the extent allowed by applicable federal state and local laws, HotB and/or Maypoint Hospitality LLC to conduct its own investigation of my references, employment history and education and, further, authorize the references and prior employers I have listed to disclose to the Company information related to my employment history and qualifications for the position for which I am applying, without giving me prior notice of such disclosure.

Initial: I understand and expressly agree that if employed by the Company, storage areas provided for me (locker, desk, etc.) are open to investigation by the Company without prior notice to me.

Initial: I agree to undergo a pre-employment physical examination consistent with federal and state law if required for my position.

Initial: I agree to submit, if required, to legally permissible drug testing upon an offer of employment from HotB and prior to starting work. I agree that any offer of employment is contingent upon my receiving a result satisfactory to the Company.

Initial: New Jersey Applicants: I understand that the Company may not ask or require applicants to disclose past salary, wages or other compensation

My signature below certifies that I agree to be bound by the terms and conditions stated in this application, which contains all the understandings between the Company and me concerning the topics addressed herein, and supersedes any prior inconsistent understandings between the Company and me on such issues.

APPLICANT'S SIGNATURE                              DATE

This application will only be considered for 30 days. If you have not been hired within 30 days of submitting this application and you wish to continue to be considered for employment, you must complete another application.