BECOME A 215 TACOS TEAM MEMBER! Name * First Name Last Name Date * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * Country (###) ### #### Email * Date Available * Desired Salary * Positioned Applied For * Are you a citizen of the United States? * Yes No If no, are you authorized to work in the United States? * Yes No Have you ever worked for this company? (Includes 717 Tacos and 717 Burritos) * Yes No If yes, when and for what company? * Have you ever been convicted of a felony? * Yes No If yes, please explain: Education High School * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date Started * MM DD YYYY Date Completed * MM DD YYYY Did you graduate? * Option 1 Option 2 Diploma * College * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date Started * MM DD YYYY Date Completed * MM DD YYYY Did you graduate? * Option 1 Option 2 Degree * Other * Previous Employment Company * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Job Title * Responsibilities * Date Started * MM DD YYYY Date Ended * MM DD YYYY Starting Salary * $ Ending Salary * $ Reason for Leaving * Company * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Job Title * Responsibilities * Date Started * MM DD YYYY Date Ended * MM DD YYYY Starting Salary * $ Ending Salary * $ Reason for Leaving * References Name * First Name Last Name Relationship * Company (if applicable) Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Name * First Name Last Name Relationship * Company (if applicable) * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Military Service Branch Start Date MM DD YYYY End Date MM DD YYYY Rank at Discharge Type of Discharge If other than honorable, please explain: 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 release. Name * First Name Last Name Date * MM DD YYYY Thank you!
