MESENBURG CATERING
PRE-EMPLOYMENT QUESTIONAIRE

INSTRUCTIONS TO APPLICANT:
Answer all questions accurately and completely.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
PERSONAL INFORMATION
* NAME:  
* EMAIL ADDRESS:  
STREET: 
CITY: 
STATE: 
ZIP CODE: 
TELEPHONE:  
REFERRED BY:  
EMPLOYMENT DESIRED
POSITION:  
DATE YOU CAN START:  
SALARY DESIRED:  
GENERAL INFORMATION
ARE YOU CURRENTLY EMPLOYED?:    Yes    No
IF SO, MAY WE INQUIRE YOUR PRESENT EMPLOYER?:    Yes    No
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S.?:    Yes    No
Have you ever applied or worked for this Company?:    Yes    No
If yes, explain:  
Do you currently have immediate family working for this company?:    Yes    No
If yes, give name (s) and relationship (s):  
EDUCATION HISTORY List your most recent schooling
Dates Attended School School Name/Location Did You Graduate? Subjects Studied
High School
College
Trade, Business School
SKILL INFORMATION (List any subjects of special study/research work or special training/skills)
U.S. MILITARY SERVICE (OPTIONAL)
HAVE YOU SERVED IN THE U.S. MILITARY?(optional):    Yes    No
RANK/SKILLS:  
EMPLOYMENT HISTORY (List your last 3 employers, starting with the most recent)
Month/Year Name of company/
Complete Address
Supervisor/
Telephone
Nature
of Duties
From/To
From/To
From/To
REFERENCES (List the names of three persons, not related to you, whom you have known at least one year)
Name Occupation Address Telephone Years Known
Mesenburg Catering Interview Information Only
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

I understand that if employed, there will be Company policies and practices that are necessary to abide to.
• I hereby assert that the above information is correct and accurate.
• I agree that I have read, understand and agree to each of the above statements.

• Fill out your phone number, name, and today's date into the fields below to agree and submit this application.
* Phone Number: 
* Name: 
* Date: 


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