Application for employment                                Position(s) desired__________________________

Lucullan's Italian Grill

400 Main * Ames, Iowa * 50010 * 232-8484

Do not waste your time completing this application until you have read our profile to see if you qualify to work.

Name____________________________Phone #_____________Cell #___________________Date__________

Street Address_____________________________________________City_______________________________

Address to send W-2_________________________________________________________________________

E-mail address_________________________________________

Emergency contact:  Name____________________________________Phone_____________________

Social Security Number_________________________________Are you over 21?_____

Who do you know that works here?____________________________________________________________

Pay range_______________

1.  Do you have any physical ailments that could be aggravated by work or prevent you from doing this job?  Explain________________________________________________________________________________________

2.  Do you have any time-off requirements? for weddings? holidays?  vacations? explain________________________________________________________________________________________

3.  Do you have a lease in your name?_________Expires_______

4.  By signing this application you will be making a minimum of a one year commitment to this job:  O.K.______Not O.K.______

5.  When do you plan to leave Ames?______________________

6.  What is the longest job held?  Explain___________________

7.  How many hours/shifts do you want?_______________________________________________________________

8.  Please write your schedule on the back of the application.

Work References:

Most recent employer_______________________________________Supervisor_______________________________

Phone number__________________________________________________City/State___________________________

Worked from_____/______ to ______/_______ Job title____________________________

Ending pay__________Reason for leaving________________________________

Restaurant/other employer _________________________________Supervisor________________________________

Phone number____________________________________________City/State_________________________________

Worked from_____/______ to ______/_______ Job title___________________________

Ending pay__________Reason for leaving_______________________________

The facts set forth in my application for employment are true and complete.  I understand that if employed, false statements on this application may lead to termination.  I authorize investigation of all statements contained herein, and grant permission for release of information from previous employers and references.

Signed_____________________________________________________      Dated___________________

Be sure to complete the reverse side of the application!

Please write your class schedule plus any other on-going conflicts here. 

           Friday     Saturday     Sunday    Monday    Tuesday   Wednesday  Thursday

8:00___________________________________________________________________

9:00___________________________________________________________________

10:00__________________________________________________________________

11:00__________________________________________________________________

12:00__________________________________________________________________

1:10___________________________________________________________________

2:10___________________________________________________________________

3:10___________________________________________________________________

4:10___________________________________________________________________

5:00___________________________________________________________________

6:00___________________________________________________________________

7:00___________________________________________________________________

8:00___________________________________________________________________

                    Available

All ISU Graduations (Mid May, Early Aug. & Mid Dec.)            yes   no

Mother's Day (2nd Sunday in May)      yes   no

ISU Parent's Weekend        yes   no

Valentine's Weekend, February 14+         yes   no

New Year's Eve         yes   no

I will be available for a minimum of one year       yes   no

I will be here for the summer.         yes   no

I will be here for spring break.        yes   no

I will be here for fall break.         yes   no

I have read the above and understand that I cannot schedule conflicts with the times listed above if I have indicated that I am available. 

Signed________________________________________________________Dated_________________________