APPLY TO WORK AT CRU CELLARS Name * First Name Last Name Email * Date of Application * MM DD YYYY Phone * (###) ### #### Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Are you 18 years of age or older? * Yes No Are you either a U.S. citizen or an alien authorized to work in the U.S.? * Yes No Which location are you applying for? Palma Ceia CHG Any Location Position Desired * Server Server Assistant/Host Bartender Line/Prep Cook Dishwasher Kitchen Management Front of House Management Other Start Date Available * MM DD YYYY Do you prefer: * Full Time Part Time Both Have you previously worked for Cru Cellars? * Yes No If yes, which location and dates of employment: Employment History Please list all previous employment, beginning with the most recent. Most Recent/Current Employer Employer Name (1) * Position Held (1) * Employer Address (1) * Address 1 Address 2 City State/Province Zip/Postal Code Country Supervisor's Name (1) * Contact Number (1) * (###) ### #### May we contact this employer? * Yes No Are you currently employed here? * Yes No Dates of Employment (1) * Reason for Leaving (1) * Job Duties & Responsibilities (1) * Employer Name (2) Position Held (2) Employer Address (2) Address 1 Address 2 City State/Province Zip/Postal Code Country Supervisor's Name (2) Contact Number (2) (###) ### #### May we contact this employer? Yes No Dates of Employment (2) Reason for Leaving (2) Job Duties & Responsibilities (2) Employer Name (3) Position Held (3) Employer Address (3) Address 1 Address 2 City State/Province Zip/Postal Code Country Supervisor's Name (3) Contact Number (3) (###) ### #### May we contact this employer? Yes No Dates of Employment (3) Reason for Leaving (3) Job Duties & Responsibilities (3) Education High School Graduated? Yes No Still in School Not Applicable Technical School Graduated? Yes No Still in School Not Applicable College/University Graduated? Yes No Still in School Not Applicable Post Graduate Education Graduated? Yes No Still in School Not Applicable About you Why do you want to work at Cru Cellars? * Authorization and Acknowledgements By submitting this application, I affirm that the information I have provided in this application is true to the best of my knowledge, information and belief, and I have not knowingly withheld any information requested. I understand that withholding or misstating any information requested in this application is grounds for rejection of my application, and that providing false or misleading information in this application is grounds for discharge. I authorize the company to verify my references, record of employment, education record, and any other information I have provided. Unless otherwise noted, I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to such inquiry or disclosure. Referred By: Thank you for you interest in working for Cru Cellars!