The Original Garcia's Kitchen - Albuquerque, New Mexico

To ensure a timely response, please fill in as much information as possible in the form below.

Step One: Personal Information

First Name		Social Security No.
Last Name		Email address
Present Address		Mailing Address
City		City
State		State
Zip Code		Zip Code
Home Phone No.		Cell Phone No.
Referred By

Step Two: Employment Desired

Position		Date You Can Start
Salary Desired		Ever Applied/Worked With This Company Before?	Yes No
Are You Employed?	Yes No	Where did you apply/work?
If so, may we inquire of your present employer?	Yes No	When did you apply/work?
Have you ever been convicted of a felony?	Yes No
If yes, please explain		Location desired

Step Three: Education History

GRAMMER	SCHOOL	HIGH	SCHOOL
Name of school		Name of school
Location		Location
Years Attended		Years Attended
Did you graduate?		Did you graduate?
Subjects studied		Subjects studied

COLLEGE	EDUCATION	TRADE, BUSINESS OR	CORRESPONDENCE SCHOOL
Name of school		Name of school
Location		Location
Years Attended		Years Attended
Did you graduate?		Did you graduate?
Subjects studied		Subjects studied

Step Four: Former Employers

YOUR CURRENT OR	LAST EMPLOYER	YOUR 3RD TO	LAST EMPLOYER
Name of Employer		Name of Employer
Address		Address
Dates Worked Month and Year		Dates Worked Month and Year
Salary		Salary
Position		Position
Reason for leaving		Reason for leaving

YOUR 2ND TO	LAST EMPLOYER	YOUR 4TH TO	LAST EMPLOYER
Name of Employer		Name of Employer
Address		Address
Dates Worked Month and Year		Dates Worked Month and Year
Salary		Salary
Position		Position
Reason for leaving		Reason for leaving

Step Five: References

GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR

	NAME	ADDRESS	BUSINESS	YEARS KNOWN
1.
2.
3.

Step Six: Authorization & Submit

"By submitting this information, 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 above to 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."