Welcome to Havana Hideout

Team Member Employment Application


Personal Information
Position Applied For:		Location

Name		Email

Street Address	Apt/Suite	Social Security Number

City	State	Zip Code	Date Available to Work

Home Phone	Other Phone	Position Type
		Part TimeFull Time TemporaryEither

Have you ever filed to work at Havana Hideout before?		YesNo
Have you ever been employed by Havana Hideout before?		YesNo
Are you 18 years-old or older? Note: To work behind the bar you must at least be 21 years-old.		YesNo
Do you have proof of eligibility to work?		YesNo
Are you legally eligble for employment in the US?		YesNo
Have you ever been convicted of a felony in the last seven (7) years?		YesNo
Such conviction may be relevant if job related, but does not bar you from employment.
Please Explain:


Employment Experience

Employer	Telephone	Dates Employed

Address	City	State	ZipCode

Your Job Title		Starting Salary	Per

Immediate Supervisor Name and Title		Ending Salary	Per

Reason for leaving:

Summarize Your Work Experience

May we contact this employer as a reference?		YesNo

Employer	Telephone	Dates Employed

Address	City	State	ZipCode

Your Job Title		Starting Salary	Per

Immediate Supervisor Name and Title		Ending Salary	Per

Reason for leaving:

Summarize Your Work Experience

May we contact this employer as a reference?		YesNo

Employer	Telephone	Dates Employed

Address	City	State	ZipCode

Your Job Title		Starting Salary	Per

Immediate Supervisor Name and Title		Ending Salary	Per

Reason for leaving:

Summarize Your Work Experience

May we contact this employer as a reference?		YesNo

When would you be available to start?		How many hours per week can you work?

Do you have reliable transportation?		YesNo
Do you have any relatives currently employed by Havana Hideout?		YesNo
Please list:

Can you lift at least 50 lbs. of weight?		YesNo


Havana Hideout is an equal opportunity employer. Applicants will be considered without any discrimination based upon race, color, religion, sex, national origin, age, marital status, disability, or veteran status or any other type of discrimination prohibited by any local, state, or federal anti-discrimination ordinance, law, or regulation. I, the undersigned applicant, certify that the information contained in this application is accurate and complete to the best of my knowledge, and that deliberate falsification of this information is grounds for dismissal. I consent to Havana Hideout making a thorough investigation of my past employment. I hereby acknowledge that I have read the above, understand, and agree to it.

Applicant Signature (Please type as you would legally sign)