BLUSUSHI „The Art of Sushi and Outrageous Cocktails‟

employment opportunity LOCATION____________ DATE______________

APPLICANT INFORMATION
Last Name First M.I. Date

Street Address Apartment/Unit #

City State ZIP

Phone E-mail Address

Date Available Social Security No. Desired Salary

Position Applied for

Are you a citizen of the United States? YES NO If no, are you authorized to work in the U.S.? YES NO

Have you ever worked for this company? YES NO If so, when?

Have you ever been convicted of a felony? YES NO If yes, explain

EDUCATION
High School Address

From To Did you graduate? YES NO Degree

College Address

From To Did you graduate? YES NO Degree

Other Address

From To Did you graduate? YES NO Degree

REFERENCES
Please list three professional references.

Full Name Relationship

Company Phone ( )

Address

Full Name Relationship

Company Phone ( )

Address

Full Name Relationship

Company Phone ( )

Address
 BLU Sushi employment opportunity p.2

PREVIOUS EMPLOYMENT

Company Phone ( )

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To Reason for Leaving

May we contact your previous supervisor for a reference? YES NO

Company Phone ( )

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To Reason for Leaving

May we contact your previous supervisor for a reference? YES NO

Company Phone ( )

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To Reason for Leaving

May we contact your previous supervisor for a reference? YES NO

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that
false or misleading information in my application or interview may result in my release. I authorize investigation of all statements contained
in this application as may be necessary in arriving at an employment decision. I also authorize any previous employers to release
information contained in any employee records to this potential employer.
I also understand that otherwise defined by law, that any employment relationship with this organization is an “AT WILL” nature which
means that the employee may resign at any time and the employer may discharge the employee at any time without cause.
In the event of employment, I understand that false or misleading information given in any application, interview, or any act deemed
dishonest by management might result in discharge without notice. I understand that I will be required to adhere to rules and regulations
of the employer.

Signature Date

Thanks for your interest and desire to join our crew of dedicated pros. We keep all our applications and share them between our three locations in
Southwest Florida. While we hope to call all applicants, we encourage you to check back at the location of application, between the hours of 2pm-4pm.
ONLY

Interviewed by:_____________________________ Locations: FMY NPL GTC

Availability: MnD TuD WeD ThD FrD SaD SuD

MnN TuN WeN ThN FrN SaN SuN Late Nights?