Sweet O Lounge Employment Application, Page 1

(* = REQUIRED)

First Name*:

Last Name*:

Phone Number*:

Email*:

Referred By:

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Sweet O Lounge Employment Application, Page 2

EMPLOYMENT DESIRED

(* = REQUIRED)

Position*:

Start Date*: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 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 2007

Salary*:

Are You Currently Employed*? YES   NO

May We Contact Your Employer*? YES   NO

Have You Applied With Us Before*? YES   NO

If “YES”, When?

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Sweet O Lounge Employment Application, Page 3

EDUCATION HISTORY

(* = REQUIRED)

High School

Graduate or Equivalent/GED*: YES   NO

Years Attended: TO

Name:

Location (City, State):

Subjects Studied:

College/Trade/Business/Correspondance School

Graduate: YES   NO

Years Attended: TO

Name:

Location (City, State):

Subjects Studied:

Subjects of special study/research/work or special training/skills:

U.S. Military or Naval Service

Division:

Last Rank:

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Sweet O Lounge Employment Application, Page 4

EMPLOYMENT HISTORY

(* = REQUIRED)

Former employers, starting with last one first.

EMPLOYER 1

Name:

Address, City, State, ZIP:

Salary:

Last Position Held:

Reason For Leaving:

EMPLOYER 2

Name:

Address, City, State, ZIP:

Salary:

Last Position Held:

Reason For Leaving:

EMPLOYER 3

Name:

Address, City, State, ZIP:

Salary:

Last Position Held:

Reason For Leaving:

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Sweet O Lounge Employment Application, Page 5

REFERENCES

(* = REQUIRED)

1.

Name:

Address, City, State, ZIP:

Business:

Years Known:

2.

Name:

Address, City, State, ZIP:

Business:

Years Known:

3.

Name:

Address, City, State, ZIP:

Business:

Years Known:

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Sweet O Lounge Employment Application, Page 6

AUTHORIZATION

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed aboveto give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

(* = REQUIRED)

INITIALS*:   DATE*: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec   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   2007

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