PRE-EMPLOYMENT QUESTIONAIRE

YOUR CONTACT INFORMATION

Name * First Last

Email Address *

Are you 18 yrs. or older? *

Are you a US Citizen or a Legal Resident of the United States? *

(Proof of identity and legal authority to work in the U.S. is a condition of employment.)

Which position are you applying for? *

YOUR WORK AVAILABILITY

How many hours per week are you available to work? *

Are you willing to work holidays / weekends? *

Please list any days of the week and/or time of day you are unavailable to work:

YOUR WORK EXPERIENCE

Where are you currently employed?

What is your position and duties?

How many years of restaurant or food service experience do you have? *

If referred, please include their name:

If Available, Attach a Copy of Your Resume

Word or PDF Documents Only

LEGAL NOTICES AND SIGNATURE

I understand that this questionnaire and any attachments are the property of Crepe360, LLC & Crepe Revolution Restaurant.

I certify that the information contained in this questionnaire is true and correct to the best of my knowledge and understand that any falsification, misrepresentation or omission on this questionnaire is grounds for refusal to hire, or if hired, dismissal. I authorize any of the persons or organizations referenced in this application to give the Company any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this questionnaire and release all such parties and the Company from all liability for any damage that may result from furnishing such information. I authorize the Company to request and receive such information.

If employed, I understand that I will be an employee "at will" and either the Company or I may terminate my employment relationship at any time with or without notice for any reason not in violation of the law.

I agree to comply with the Company rules, regulations and policies and acknowledge that these rules, regulations and policies may be changed, interpreted, withdrawn, or supplemented at any time, and without prior notice to me.

I agree to have a physical examination and/or any associated laboratory tests, or personnel evaluation tests as required for my position and understand that my offer of employment is contingent upon my passing such physical examinations and tests.

It is also agreed and understood that under the fair credit reporting act, Public Law 91.508, as amended I have been told that any investigation conducted by the Company may include an investigative credit report, including information regarding my character, general reputation, personal characteristics and mode of living.

I agree to furnish such additional information and complete such examinations as may be required by the Company to complete my employment file.

I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS AND I AFFIRM THAT ALL INFORMATION IN THIS QUESTIONNAIRE IS TRUE AND COMPLETE.

NOTE: You must click 'YES' below and input the Date to digitally 'sign' your questionnaire. Pre-qualifying questionnaires will NOT be accepted without this action. *

Yes No

LEGACY MDG

YOUR CONTACT INFORMATION

YOUR WORK AVAILABILITY

YOUR WORK EXPERIENCE

LEGAL NOTICES AND SIGNATURE