PERSONAL INFORMATION

	NAME (LAST NAME FIRST)		SOCIAL SECURITY NO.

	PRESENT ADDRESS		CITY		STATE		ZIP CODE
	PERMANENT ADDRESS		CITY		STATE		ZIP CODE

	PHONE NUMBER		E-MAIL		REFERRED BY

	DATE OF BIRTH		HOW LONG HAVE YOU LIVED IN THIS CITY?		MARITAL STATUS [for tax purposes]   single married		DO YOU HAVE TRANSPORTATION TO WORK?   yes no

JOB INTERESTS

	POSITION DESIRED:		HRS AVAIL. MON TUES WED THURS FRI SAT SUN FROM TO

	DESIRED WAGE		TOTAL HOURS AVAILABLE PER WEEK

	HOW LONG DO YOU INTEND TO REMAIN ON THIS JOB?		ANY DAYS YOU CANNOT WORK?

	HOW SOON WILL YOU BE AVAILABLE FOR EMPLOYMENT?		BOTH DAYS AND WEEKENDS?   YES NO

	AVAILABLE UNTIL LABOR DAY? YES NO		WILLING TO WORK EVERY WEEKEND?   YES NO

	EVER INTERVIEWED WITH/BEEN EMPLOYED BY COPA CABANA? YES NO		IF YES: WHEN

	FUTURE JOB INTERESTS:

EDUCATION AND TRAINING

	HIGH SCHOOL     9 10 11 12  COLLEGE            1 2 3 4  TRADE SCHOOL    1 2 3 4		SCHOOL NAME               LOCATION               TRAINING/MAJOR               GRADUATE?

WORK EXPERIENCE PRESENT OR MOST RECENT EMPLOYER

	EMPLOYER		PHONE #

	ADDRESS		CITY                                   STATE

	MO./YR. BEGAN               MO./YR. ENDED		STARTING WAGE              ENDING WAGE

	STARTING POSITION		ENDING POSITION

	SUPERVISOR'S NAME		WHAT DID YOU LIKE MOST?

	DUTIES		WHAT DID YOU LIKE LEAST?

	MY FORMER/PRESENT SUPERVISOR WOULD RATE MY PERFORMANCE AS:   Excellent Very Good Good Fair Poor		NUMBER OF DAYS MISSED FROM WORK (do not count vacation)

	IF EMPLOYED MAY WE CONTACT YOUR PRESENT EMPLOYER?   Yes No		REASON FOR LEAVING (CHECK ONLY ONE)   Laid Off/Company or Department Closed Down Better Job Opportunity School   Didn't Like Job Fired/Asked To Resign Moved Other(please specify)

PREVIOUS EMPLOYER 

	EMPLOYER		PHONE #

	ADDRESS		CITY                                   STATE

	MO./YR. BEGAN               MO./YR. ENDED		STARTING WAGE              ENDING WAGE

	STARTING POSITION		ENDING POSITION

	SUPERVISOR'S NAME		WHAT DID YOU LIKE MOST?

	DUTIES		WHAT DID YOU LIKE LEAST?

	MY FORMER/PRESENT SUPERVISOR WOULD RATE MY PERFORMANCE AS:   Excellent Very Good Good Fair Poor		NUMBER OF DAYS MISSED FROM WORK (do not count vacation)

	IF EMPLOYED MAY WE CONTACT YOUR PRESENT EMPLOYER?   Yes No		REASON FOR LEAVING (CHECK ONLY ONE)   Laid Off/Company or Department Closed Down Better Job Opportunity School   Didn't Like Job Fired/Asked To Resign Moved Other(please specify)

PREVIOUS EMPLOYER 

	EMPLOYER		PHONE #

	ADDRESS		CITY                                   STATE

	MO./YR. BEGAN               MO./YR. ENDED		STARTING WAGE              ENDING WAGE

	STARTING POSITION		ENDING POSITION

	SUPERVISOR'S NAME		WHAT DID YOU LIKE MOST?

	DUTIES		WHAT DID YOU LIKE LEAST?

	MY FORMER/PRESENT SUPERVISOR WOULD RATE MY PERFORMANCE AS:   Excellent Very Good Good Fair Poor		NUMBER OF DAYS MISSED FROM WORK (do not count vacation)

	IF EMPLOYED MAY WE CONTACT YOUR PRESENT EMPLOYER?   Yes No		REASON FOR LEAVING (CHECK ONLY ONE)   Laid Off/Company or Department Closed Down Better Job Opportunity School   Didn't Like Job Fired/Asked To Resign Moved Other(please specify)

PERSONAL INFORMATION 

	Person to notify in case of emergency      NAME                               HOME PH:        WORK PH:       ADDRESS:          CITY:                 STATE:    ZIP:

	ARE YOU LEGAL AGE TO SERVE ALCOHOL? Yes No		IF YOU ARE A MINOR, CAN AND WILL YOU PROVIDE:  PROOF OF AGE? Yes No       A WORK PERMIT? Yes No

	IF EMPLOYED, CAN YOU SUBMIT VERIFICATION OF YOUR LEGAL RIGHT TO WORK IN THE UNITED STATES? Yes No		HAVE YOU BEEN CONVICTED OF A CRIME WITHIN THE PAST 10 YEARS? Yes No  IF YES, EXPLAIN

	SOME OF COPA CABANA'S POSITIONS REQUIRE HANDLING OF/ACCOUNTABILITY FOR LARGE SUMS OF MONEY.  ARE THERE ANY REASONS YOU MAY NOT BE ABLE TO DO SO? Yes No     IF YES, PLEASE EXPLAIN

REFERENCES (LIST THREE WORK REFERENCES)

	NAME:                             TITLE:                    COMPANY:          ADDRESS:                          PHONE:
	NAME:                             TITLE:                    COMPANY:          ADDRESS:                          PHONE:
	NAME:                             TITLE:                    COMPANY:          ADDRESS:                          PHONE:

	WAIVER. I HEREBY GIVE COPA CABANA RESORT PERMISSION TO CONTACT ALL OF MY REFERENCES FOR INFORMATION   (INITIALS)

	I UNDERSTAND AND AGREE THAT: This is an application for employment and not an employment contract. Any misrepresentation or omission in my Application For Employmen or related papers or oral interviews may be justification for refusal of employment, or if employed, termination of employment. Copa Cabana, Inc. may investigate my entire work history, law enforcement and traffic records and may verify data given in my Application For Employment, related papers or oral interviews. I authorize such investigation and the giving and receiving of any information sought by Copa Cabana, Inc. and shall be for no definite period of time. Copa Cabana, Inc. may change any wages, benefits and conditions of employment any time. Copa Cabana, Inc. may terminate my employment at any time without liability except for wages or salary earned as of the date of such termination. Business needs will make the following conditions mandatory: overtime, shift work, a rotating work schedule and a work schedule other than Monday through Friday. If employed, I hereby agree to abide by the rules and regulations of Copa Cabana, Inc. Including those which address job-related dress and grooming standards. I understand these rules and regulations may be amended or revised by Copa Cabana, Inc. at any time and that nothing in this application creates, or will create, an express or implied contract of employment between Copa Cabana, Inc. and me. I acknowledge Copa Cabana, Inc. has the right to conduct random drug tests and to search its property, such as lockers or desks, at any time without prior notice or permission. I agree to fully cooperate in any investigation of missing Company property by submitting to a search of my person or property. I further understand that refusal to coooperate in such investigation may result in my discharge. Copa Cabana Resort Hotel & Suites is an equal opportunity employer. We select each employee based soley on job-related qualifications, regardless of race, color, creed, sex national origin, age, disability or other membership in a proteced group under static, federal or local Equal Opportunity Laws.

	SIGNATURE:		DATE:

	HOW DID YOU LEARN ABOUT COPA CABANA, INC. AS A PLACE OF EMPLOYMENT?