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APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION Date

Name Social Security #

Address City State Zip

Phone Number (Day) Phone Number (Evening)

Position applied for Store applied at

How did you hear about Taco Del Mar?

EMPLOYMENT HISTORY Please list your last three employers, starting with the most recent:

From to May we contact your current supervisor? Yes No

Company Position

Address City State Zip

Supervisor PhoneReason for leaving

Starting Wage Ending Wage

From to

Company Position

Address City State Zip

Supervisor Phone

Reason for leaving

Starting Wage Ending Wage

From to

Company Position

Address City State Zip

Supervisor Phone

Reason for leaving

Starting Wage Ending Wage

AVAILABILITY Date available to start

What type of Employment are you looking for? Full Time Part Time Seasonal Are there any specific days or times you would not be available to work?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Day

Night

MORE, OTHER SIDE

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EDUCATION

High School Last grade completed Year

College Last grade completed YearTechnical Training Other

Subject of special interest or study

REFERENCES Please do not include relatives.Name Phone Years known

Address City State Zip

Occupation

Name Phone Years known

Address City State Zip

Occupation

Name Phone Years known

Address City State Zip

Occupation

OTHERAre you at least 18 years of age? Yes No

Have you ever been convicted of a felony? Yes No If yes, please explain:

Are you legally entitled to work in the United States? Yes

No

Have you ever been discharged or asked to resign by any of your previous employers?Yes No If the answer is yes, please explain:

Have you ever worked for this Company before? Yes No

When Where

It is the policy of Taco Del Mar that all employees and applicants for employment areafforded equal opportunity without regard to race, color, creed, sex, sexual orientation, age,national origin, religion, or non-job related disability. I understand and acknowledge that any

employment relationship with Taco Del Mar is of an at-will nature. This means that I mayresign at any time with or without notice and Taco Del Mar may terminate my employment atany time with or without cause and with or without notice. I certify the information on thisapplication is true, complete and correct. I hereby authorize the investigation of my pastemployment, education, and activities and I release from all liability all person's companies andcorporations supplying such information. I understand that false answers, statements orsignificant omissions made by me on this form shall be sufficient for denial of employment ordischarge. By signing this application you are certifying that all the information you haveprovided is true and correct.

Signed DateRev. March 2006