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Employment Application
Newport / Naples Rib Company – An Equal Opportunity Employer

Sunday, April 23, 2017

Name (last, first and middle)


Present street address

City

State

ZIP


Mailing address (if different from above)

City

State

ZIP


Email address


Home phone


Message or cell phone


Position applying for


Salary desired


Date you can start


How were you referred to us? (check one)
Newspaper advertisement   Walk-in
Rib Company Employee   Other
If referred by a Rib Company employee, list their name here


Are you applying for:
Full time  Part time  Temporary

Location:
Naples (Long Beach)  Newport (Costa Mesa)

Shifts you are available: (check all that you can work)
Monday  Tuesday  Wednesday
Thursday  Friday  Saturday  Sunday
Days only  Nights only  Any time

Have you ever worked for us before?
Yes   No
If yes, where?
If yes, when?

Are you at least 18 years old?
Yes   No
If under 18, hire is subject to verification that you are of minimum legal age.

If hired, can you present evidence that you have the legal right to work in the US?
Yes   No

Have you ever been convicted of a felony or misdemeanor? (Convictions for marijuana-related offenses that are more than two years old need not be listed.)  Yes  No
If yes, explain:

Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of the offense, surrounding circumstances and the relevance to the position applied for may however be considered.

Are you able to perform the essential functions of the job for which you are applying with or without reasonable accomodation?  Yes  No
If no, please describe the functions that cannot be performed:

Note: We comply with ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform the essential functions.


EDUCATION HISTORY

High School

# Years Attended

Did you graduate?

Courses/Degree


College

# Years Attended

Did you graduate?

Courses/Degree


Graduate School

# Years Attended

Did you graduate?

Courses/Degree


Trade School

# Years Attended

Did you graduate?

Courses/Degree



SKILLS

Language 1:

Speak  Read  Write
Level:   Fair  Good  Fluent

Language 2:

Speak  Read  Write
Level:   Fair  Good  Fluent

Office Skills:
Typing - WPM
Shorthand
Calculator/Ten Key

Computer Skills:
Excel   Word
Other:

Please list any special skills, training or education that may be applicable to the position you are applying for:


PREVIOUS EXPERIENCE
- List your previous employers, starting with the most recent

1. Name/Address

Start Date

Final Date

Final Salary

Title/Position

Description of work

Reason for leaving

Supervisor

May we contact?
Yes No
Phone #

2. Name/Address

Start Date

Final Date

Final Salary

Title/Position

Description of work

Reason for leaving

Supervisor

May we contact?
Yes No
Phone #

3. Name/Address

Start Date

Final Date

Final Salary

Title/Position

Description of work

Reason for leaving

Supervisor

May we contact?
Yes No
Phone #

4. Name/Address

Start Date

Final Date

Final Salary

Title/Position

Description of work

Reason for leaving

Supervisor

May we contact?
Yes No
Phone #


BUSINESS REFERENCES
- List three references who are not relatives or personal friends

1. Name/Relationship

Title

Company Name

Phone


2. Name/Relationship

Title

Company Name

Phone


3. Name/Relationship

Title

Company Name

Phone


MILITARY SERVICE
Describe any military service skills that may be relevant to the job you are applying for


AUTHORIZATION

Before sending your application, please take a moment to make sure you have completed all of the questions. Failure to complete all of the questions may delay or prevent the processing of your application. By pressing the button below you are stating that you have read and understand the foregoing and agree unconditionally to the foregoing:

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by me and the company's designated representative.

Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company I am entitled to copies of any such public records obtained by the Company. If I am not hired as a result of such information, I am entitled to a copy of any such records.



Naples Rib Company
(562) 439-7427

Newport Rib Company
(949) 631-2110