Please fill out all sections. You must answer all questions in order for us to process your application. If the question does not apply to you please put in na for not applicable.

Applicant Information

Applicant Name
Home Phone
Other
Email Address
Current Address:
Number and street
City
State & Zip
How were you referred to Chaparro’s Tamales?:
Resume - If you have a plain-text resume, paste it into the box below.

Employment Positions

Position(s) applying for:
Are you applying for:

• Temporary work – such as summer or holiday work? Y or N
• Regular part-time work? Y or N
• Regular full-time work? Y or N

What days and hours are you available for work?
If applying for temporary work, when will you be available?
If hired, on what date can you start working?
Can you work on the weekends? Y or N
Can you work evenings? Y or N
Are you available to work overtime? Y or N
Salary/Wage desired: $

Personal Information:

Have you ever applied to / worked for Chaparro’s before? Y or N
If yes, please explain (include date):
Do you have any friends, relatives, or acquaintances working for Chaparro’s? Y or N
If yes, state name & relationship:
If hired, would you have transportation to/from work? ] Y or N
Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age.) Y or N
If hired, would you be able to present evidence of your U.S. citizenship
or proof of your legal right to work in the United States? Y or N
If hired, are you willing to submit to and pass a controlled substance test? Y or N
Are you able to perform the essential functions of the job for which you are applying, either with / without reasonable accommodation? Y or N
If no, describe the functions or work that cannot be performed
Do you have a food handlers permit? Y N
Is there any reason you cannot obtain a food handlers permit Y or N
If you are hired by Chaparro’s Tamales you will be required to obtain a food handler permit. Do you agree with this Y or N.

(Note: Chaparro’s Tamales complies with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional.)

Have you ever been convicted of a criminal offense (felony or misdemeanor)? Y or N
If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case or cases.

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Education, Training and Experience

High School:
School name:
School address, city, state, zip:
Number of years completed:
Did you graduate? Y or N
Degree / diploma earned:

College / University:
School name:
School address:
School city, state, zip:
Number of years completed:
Did you graduate? Y or  N
Degree / diploma earned:

Vocational School:
Name:
Address:
City, state, zip:
Number of years completed:
Did you graduate? Y or N
Degree / diploma?:

Military Service:
Branch:
Rank in Military:
Total Years of Service:
Skills/duties:
Related details:

Employment History

Are you currently employed? Y or N
If you are currently employed, may we contact your current employer? Y or N

Below, please describe past and present verifiable employment positions, dating back five years. Please account for all periods of unemployment. Even if you have attached a resume, this section must be completed.

Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip :
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references? Y or N

Next Employer:

Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references? Y or N

Next Employer:

Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references? Y or N

References

List below three persons who have knowledge of your work performance within the last four years. Please include professional references only.

Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:

Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:

Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:

Please Read: If you are hired you will be required to initial each paragraph and sign this.
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by Chaparros, terms for my immediate expulsion from Chaparro’s.
Place your initials here:

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or Chaparro’s.
Place your initials here:

I permit Chaparro’s to examine my references, record of employment, education record, and any other information I have provided. 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 Chaparro’s, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
Place your initials here:

Applicant's Name: ______________________________

Date: _________________________________