We consider all applicants without regard to race, color, religion, sex, marital status, sexual orientation, national origin, age, disability, arrest and court
record or status as a Vietnam-era or special disabled veteran in accordance with federal law. In addition, we comply with applicable state and local laws
prohibiting discrimination in every jurisdiction in which we operate.
Please print. Answer all questions completely and provide

Restaurant Suntory USA Inc

exact dates.

DATE:
INTERVIEWED BY:

Employment Information
LAST NAMEFIRST NAMEMIDDLE NAMETODAY’S DATECURRENT STREET ADDRESSCITYSTATEZIPPREVIOUS STREET ADDRESSCITYSTATEZIPHOME PHONEALTERNATE PHONECELLULAR/PAGER

HOW LONG HAVE YOU LIVED AT CURRENT ADDRESS?
YRMOHOW LONG?
YR

EMAIL ADDRESSMOWHEN ARE YOU AVAILABLE TO START?

IN CASE OF EMERGENCY CONTACT:NAMETELEPHONESCHOOL NAME

CITY/STATEHOW DID YOU HEAR OF US?
EDUCATIONMAJOR

GRADE POINTTYPE OF DEGREE

HIGH SCHOOLHAVE YOU EVER APPLIED OR WORKED FOR
THIS COMPANY BEFORE?

COLLEGETRADE, BUSINESSOR OTHEREMPLOYMENT HISTORY: PLEASE LIST YOUR LAST 3 JOBS, MOST RECENT FIRST.
MOST RECENT JOB: FROM//TOARE YOU CURRENTLY EMPLOYED? ______ IF YES, WHERE?
//PRIOR JOB FROM//TO//NEXT PRIOR JOB FROM//TO//TITLECOMPANY & DIVISIONADDRESSTELEPHONE
SUPERVISOR/TITLE
TYPE OF BUSINESSDUTIES(S)/RESPONSIBILITIESREASON FOR LEAVING THIS JOB
MAY WE CONTACT THEM FOR A REFERENCE?

YESNO

MAY WE CONTACT THEM FOR A REFERENCE?

IF NOT, WHY?_______________________________________________________YESNOIF NOT, WHY?______________________________________________________

MAY WE CONTACT THEM FOR A REFERENCE?

BUSINESS REFERENCES (CO-WORKERS & PREVIOUS MANAGERS)NAME/TITLE

WHAT POSITION ARE YOU APPLYING FOR?

COMPANY

PHONE

NAME/TITLE

DESIRED BENEFITS

YES

NO

IF NOT, WHY?_______________________________________________COMPANYPHONELIST ALL PERIODS OF 4 WEEKS DURATION OR MORE WHENYOU WERE “BETWEEN JOBS”, NOT EMPLOYED/WORKING.

FROM:

TO:REASON:FROM:WHAT IS THE “IDEAL” NEXT POSITION FOR YOU?
FOREIGN LANGUAGE PROFICIENCYHAVE YOU EVER BEEN LICENSED OR BONDED?

TO:rev. 12.18

REASON:

WHAT MATTERS MOST TO YOU IN A JOB?
WRITEYES

WHAT SPECIAL SKILLS CAN YOU CONTRIBUTE?

SPEAKNOREAD

HAVE YOU EVER SERVED IN THE U.S. ARMED FORCES?

YESNOARE YOU AT LEAST 18 YEARS OF AGE?

YESNOWILL YOU USE YOUR OWN TRANSPORATION OR PUBLIC TRANSPORTATION FOR WORK?

LIST YOUR MINIMUM TO PREFERRED SALARY OR HOURLY PAY RANGEPREFERRED WORK DAYS & HOURS?

ANY DAYS OR HOURS NOT AVAILABLE?

IS THERE ANYTHING THAT WOULD PREVENT YOU FROM PERFORMING, IN A REASONABLE AND SAFE MANNER, THE ACTIVITIES INVOLVED, IN THE TYPE OFPOSITION FOR WHICH YOU ARE SEEKING EMPLOYMENT?
YESNOIF YES, PLEASE EXPLAIN:
IS THERE ANYTHING ELSE YOU WANT US TO KNOW ABOUT YOU?

WHO ELSE DO YOU KNOW WHO MAY BE LOOKING FOR WORK?

NAMEPHONE NUMBERNAMEPHONE NUMBERPRE-EMPLOYMENT STATEMENT Please read the following statements and sign in the space provided below. I understand and agree that:
1. I am submitting an application for employment to Restaurant Suntory USA Inc (“the Company”).
2. The information I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume or any other materials, or during any interviews, can be justification
for refusal of employment or, if employed, termination from employment.
3. Any offer of employment I may receive is contingent upon my successful completion of any screening process, including the Company receiving references that they consider satisfactory.
4. In processing this application, the Company may verify the information provided by me, or may procure or have prepared a consumer or investigative consumer report concerning my work history, education, character, reputation, background,and conviction record (if and as permitted by law). I understand that upon written request to the Company, I will be informed of whether an investigative consumer report was requested and given full information as to the nature and scope of thisinvestigation.
5. I authorize and request that my present and former employers, educational institutions attended, and references furnish information regarding my work history, education, character, reputation, and background. I hereby release the Company andall providers of information from any and all liability relating to or arising from furnishing the requested information.
6. After receiving an offer of employment, I may be required by the Company to undergo a pre-employment medical examination and/or screening for alcohol and/or drugs, with the offer of employment conditioned on the result of such examination or screening. If employed, I agree to submit to a medical examination (or screening for alcohol and/or drugs) at the Company’s request, consistent with applicable law. I hereby consent to having the results of any pre- or post-employment medical examinations and/or screening for alcohol and/or drugs disclosed to the appropriate company official.
7. I agree to maintain the confidentiality of any proprietary information of the Company, including client lists, personnel information, internal communications, computer programs, price lists, business plans, financial statements, information pertaining to lawsuits or other legal proceedings, training programs, and product development. I agree that the use, communication, duplication and/or distribution of such information for personal benefit or for the benefit of another person, company, orentity other than the Company may be grounds for disciplinary action, up to and including dismissal, and may also result in legal action.
8. This application is not an implied or express contract of employment and cannot create a contract of employment for any specific period. I understand that if I am offered employment, to the extent not inconsistent with any applicable collective
bargaining agreement, my employment will be "at will" and can be terminated at any time by me or the Company, with or without cause or prior notice.

Signature

Print Name

Date

ARBITRATION POLICY
Because of the delay and expense that results from the use of the federal and state court systems, the Company requires, as a term and condition of employment and/or continued employment, that all of its employees agree to submit to binding arbitration any controversies concerning compensation, employment, or termination of employment, rather than to use the court system. If I am offered employment, I expressly and knowingly agree that if any dispute should ever arise between myself
and the Company and/or arising out of any transaction or occurrence at my workplace, concerning any aspect of my employment including, but not limited to, my compensation, the terms and conditions of my employment, harassment and/or discrimination of myself in the workplace and/or connected with work, or termination of my employment, such dispute(s) shall be submitted to binding, mandatory and exclusive arbitration and I shall not attempt to use any court or judicial system to
adjudicate such dispute(s).

Signature

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