www.cubalibrerestaurant.com

1 Check which you are applying for Kitchen / Back-of-House - Position(s) : _____ Front-of-House / Service Staff - Position(s) : _____ Nightlife / Security / Greeter Management Sales OtherWe are an equal opportunity employer. Our recruiting and hiring practices are based solely on job-related criteria and that Cuba Libre Restaurant & Rum Bar does not discriminate on the basis of any federal, state or locally protected class. Please answer all questions. A resume is not a substitute for this application. COMPLETE ALL SECTIONSPERSONAL INFORMATION (PRINT) DATE / / DAYS AND HOURS AVAILABLE TO WORKEDUCATIONLEGALHow did you hear about us? EmailName (Print)

2 Last First MiddleHome Address City State Zip CodePhone number to reach you home CellSocial Security ___ ___ ___ Last 4 Digits OnlyDate Available To Start Are you interested in (check all that apply) / / Full-time Part-time Casual SummerDayMondayTuesdayWednesdayThursdayF ridaySaturdaySundayFromTo Are you at least 18 years of age?

3 Are you able to travel if needed?Type of SchoolName and Location of SchoolDegree/Field of StudyNumber of Years AttendedGraduated (Check One)High SchoolName Address Ye s NoCity State ZipCollegeName Address Ye s NoCity State ZipGraduate SchoolName Address Ye s NoCity State ZipOtherName

4 Address Ye s NoCity State ZipList any special skills, certifications, licenses or military experience related to the industry:Are you legally eligible to work in the United States? Yes No (Identity and employment eligibility of all new hires will be verified as required by the Immigration Reform Control Act o6 1986)Were you ever discharged by any company? Yes No If yes, give name of company(ies)_____ Reason for discharge_____We use E-Verify to confirm employment eligibility status Revised 2-28-18 List employment starting with most recent position. Account for any time during this period that you were unemployed by stating the nature of your activities.

5 May we contact your present employer? Yes No Past Employer? Yes No Please note if you were employed under a different , Address, Phone Of EmployerPosition Held And ManagerList Major DutiesReason For LeavingFrom:_____/_____Mo. :_____/_____Mo. TitleAddress CityManagerSate Phone ( )From:_____/_____Mo. :_____/_____Mo. TitleAddress CityManagerSate Phone ( )From:_____/_____Mo.

6 :_____/_____Mo. TitleAddress CityManagerSate Phone ( )From:_____/_____Mo. :_____/_____Mo. TitleAddress CityManagerSate Phone ( )Have you previously worked for us? GuestCounts Hospitality Cuba Libre Rstaurant & Rum BarLocation_____ Position Held_____Manager_____ Dates Employed: From_____ To:_____Reason For Leaving_____EMPLOYMENT HISTORYREFERENCESPLEASE READ CAREFULLYB usiness references.

7 (Do not list relatives or friends and please indicate if you were employed under a different name)NameContact NumberTitleYear s K nownRevised 2-28-2018I understand that, with my authorization, an investigation may be made whereby information is obtained regarding references, previous employment history, general reputation, educational background, criminal history, subject to applicable federal, state and/or local the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of Cuba Libre Restaurant & Rum understand and agree that, if employed, the employment will be at will.

8 That is, either I or Cuba Libre Restaurant & Rum Bar my end the employment relationship at any time, for any reason, or for no reason. I understand that receipt of this application by Cuba Libre Restaurant & Rum Bar does not imply employment and that this application and/or any other Cuba Libre Restaurant & Rum Bar documents are not contracts of _____/_____/_____ APPLICANT S SIGNATURE DATE SIGNED