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WORK AUTHORIZATION

WORK SCHEDULE

EDUCATION

Please list any special abilities or knowledge which you have that are related to the job for which you are applying. (Please do not list those items which are related to race, sex, religion, color, national origin, age, marital status, disability or non-job related medical conditions):

In addition to work experience described in this application, what other experiences, skills or abilities do you have that should be considered in evaluating your qualifications for this job?

EMPLOYMENT HISTORY

Name of Company

Employment Start Date

Empoyment End Date

Name of Supervisor

Phone Number

Job Title

Reason for Leaving

Name of Company

Employment Start Date

Empoyment End Date

Name of Supervisor

Phone Number

Job Title

Reason for Leaving

Name of Company

Employment Start Date

Employment End Date

Name of Supervisor

Phone Number

Job Title

Reason for Leaving

REFERENCES

LEGAL

PLEASE RED THE FOLLOWING CAREFULLY AND SIGN BELOW
I declare that I am qualified to perform all the duties of the position I am seeking. I also declare that the information I have provided on this application is correct and that any false statements or omissions will justify my rejection or dismissal. I have authorize the company to contact any of my previous employers as well as any reference source to verify the facts and information I have furnished regarding information provided on this application, on my resume, or during my interview. I authorize any person(s) having knowledge to provide such information to the company, and release from liability and agree to hold harmless any person that furnishes such information in good faith, as allowed by applicable state and federal laws. I will agree to drug test, if permitted by law, to be paid for by the company. Should I become involved in a claim for worker's compensation or any other litigation after employment by the company, I will allow the company to supply my employment records (as allowed by applicable state and federal laws to an opposing party. If employed by the company, I understand that I will be an employee at will and that my employment with Desi Wok for any reason whatsoever. Should I become employed by Desi Wok, I also authorize Desi Wok to conduct any additional background checks should they become necessary at any point during my employment. I further understand that if employed by Desi Wok no representative of Desi Wok, other than the President, has any authority to modify or change my status as an employee at will and that such modifications must be in writing signed by the President. Finally, I understand that this is only an application for employment and neither an offer of or a contract of employment and no part of this application shall be constructed as an offer of employment or an employment contract. The Agreement to arbitrate accompanying this application must be read and signed in order for you to be considered for employment with Desi Wok or any of its related companies (Desi Wok). By signing the Agreement to Arbitrate I understand that the employment at will relationship will be altered.

SIGNATURE OF APPLICANT

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