"Quality is Our Priority" ™

Mmm...Jamaican Me Hungry!®

Name:

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Last, First, Middle Name

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Social Security Number (Voluntary)

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Home Phone:

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Cell Phone:

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Home Address:

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Position Applied For

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How did you Learn About Us?

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Employment Agency

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If you are under 18 years of age, can you provide required proof of your eligibility to work?

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Yes

Have you ever filed an application with us before?

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Yes

If yes, give date

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Enter date previously applied

Have you ever been employed with us before?

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Yes

If yes, give date

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Enter date previously employed with us

Do any of your friends, relatives, other than spouse, work here?

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Yes

Are you currently employed?

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Yes

May we contact your present employer

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Yes

Are you lawfully authorized to work in the United States?

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Yes

Date available for work:

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What is your desired salary?

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Are you available to work:

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Full-Time

Part-Time

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If Full-Time, please indicate 1st or 2nd shift

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1st or 2nd shift

If Part-Time, please indicate Mornings, Afternoon or Evenings

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Mornings, Afternoon or Evenings

If Temporary, please indicate dates available

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Temporary dates available

Are you currently on "lay-off" status and subject to recall?

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Yes

Can you travel if a job requires it?

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Yes

Elementary School: (Name, Address, Number of Years Completed)

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Elementary School Name, Address, Number of Years Completed

High School: (Name, Address, Course of Study, Number of Years Completed, Diploma Degree)

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High School Name, Address, Course of Study, Number of Years Completed, Diploma Degree

Undergraduate College: (Name, Address, Course of Study, Number of Years Completed, Diploma Degree)

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Name, Address, Course of Study, Number of Years Completed, Diploma Degree

Graduate Professional: (Name, Address, Course of Study, Number of Years Completed, Diploma Degree)

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Name, Address, Course of Study, Number of Years Completed, Diploma Degree

Other: (Name, Address, Course of Study, Number of Years Completed, Diploma Degree)

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Name, Address, Course of Study, Number of Years Completed, Diploma Degree

Describe any specialized training, apprenticeship, skills and extra-curricular activities.

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Describe any specialized training, apprenticeship, skills and extra-curricular activities.

Describe any job-related training received in the United States military.

Describe any job-related training received in the United States military

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Employment Experience: Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status. 1. Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

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Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

2. Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

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Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

3. Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

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Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

4. Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

Required

Employer, Address, Telephone Number(s), Job Title, Supervisor, Dates Employed, Work Performed, Reason for Leaving

List professional trade, business or civic activities and offices held.You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status:

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Professional trade, business or civic activities and offices held

Other QualificationsSummarize special job-related skills and qualifications acquired from employment or other experience.

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Other Qualifications

Specialized Skills (Check Skills/Equipment Operated)

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Terminal

PC/MAC

Typewriter

Typewriter WPM

Spreadsheet

Word Processing

Shorthand

Shorthand WPM

Production/Mobile Machinery (List)

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Production/Mobile Machinery Operated

Other Equipment Operated (List)

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Other Equipment Operated

State any additional information you feel may be helpful to us in considering your application.

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Additional Information

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING. Can you perform the essential functions of the job, for which you are applying, either with or without a reasonable accommodation?

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Yes

Reference #1:

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Reference: Name, Phone Number, Address

Reference #2:

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Reference: Name, Phone Number, Address

Reference #3:

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Reference: Name, Phone Number, Address

APPLICANT'S STATEMENT I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.

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Signature of Applicant

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Signature of Applicant

Date

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Name:

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Last, First, Middle Initial

Date:

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Date

Pre-Offer Invitation to Applicants to Self Identify as a Protected Veteran

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I IDENTIFY AS ONE OR MORE OF THE CLASSIFICATIONS OF PROTECTED VETERAN LISTED ABOVE.

I AM NOT A PROTECTED VETERAN.

I CHOOSE TO NOT SELF IDENTIFY.

Name

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Name

Job Title

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Job Title

Date

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Gender

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Male

Female

Other

Please check off the appropriate box(es). RACE/ETHNIC CATEGORY

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White - (Not of Hispanic origin) - All persons having origins in any of the original peoples of Europe, North Africa, or the Middle East.

Black - (Not of Hispanic origin) - All personal having origins in any of the Black racial groups of Africa.

Hispanic - All persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race.

Asian or Pacific Islander - All persons having origins in any of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands.

Native American or Alaskan Native - All persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribunal affiliation or community recognition.

REFERRAL SOURCE

Required

Advertisement (1)

Employee Referral (2)

Walk-in (7)

Government Agency (4)

Employment Agency (5)

College Recruitment (6)

Open House (8)

Other (9)

If other, please describe

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Other referral source

Please select one of the options below.Do you have a disability?

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Yes, I have a disability (or previously had a disability)

No, I don't have a disability

I don't wish to answer

Your Name:

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Your Name

Today's Date:

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Today's Date

Image Verification:

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On-line Application for Employment

We consider applications for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, sexual orientation, citizenship status, genetic information or any other legally protected status. We are an equal opportunity employer. Download Application for Employment instead.

CARIBBEAN FOOD DELIGHTS, INC.

PRE-OFFER INVITATION TO APPLICANTS TO SELF IDENTIFY AS A PROTECTED VETERAN

Caribbean Food Delights, Inc., is a federal contractor subject to the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (“VEVRAA”), which requires contractors to take affirmative action to employ and advance in employment:

disabled veterans defined as (a) veterans of the U.S. military, ground, naval or air service who are entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or (b) persons who were discharged or released from active duty because of a service-connected disability;

recently separated veterans defined as any veterans during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service;

active duty wartime or campaign badge veterans defined as veterans who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge bas been authorized under the laws administered by the Department of Defense; and

Armed Forces service medal veterans defined as veterans who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

If you believe you belong to any of the categories of protected veterans listed above, please indicate by checking the appropriate box below. As a government contractor subject to VEVRAA, we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. This information is being requested on a voluntary basis and will be kept confidential, consistent with applicable law. Refusal to provide the requested information will not subject you to any adverse treatment. If provided, this information will not be used in a manner inconsistent with VEVRAA.

CARIBBEAN FOOD DELIGHTS, INC.

EQUAL EMPLOYMENT OPPORTUNITY APPLICANT DATA FORM

IMPORTANT - To All Applicants: To enable us to meet government reporting regulations and maintain an Affirmative Action Plan, Caribbean Food Delights, Inc., requests that you complete this personal data form. Information will be used solely for government reporting purposes and will be detached and kept separate from your application. Any information that you choose to provide will not be considered by Caribbean Food Delights, Inc., for employment purposes and will be treated as personal and confidential. Your voluntary cooperation is appreciated.

Voluntary Self-Identification of Disability

Form CC-305 OMB Control Number 1250-0005 Expires 1/31/2020

Why are you being asked to complete this form?

Because we do business with the government, we must reach out to, hire, and provide equal opportunity to qualified people with disabilities.i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

•Blindness •Deafness •Cancer •Diabetes •Epilepsy • Autism• Cerebral palsy •HIV/AIDS •Schizophrenia •Muscular dystrophy

•Bipolar disorder • Major depression •Multiple sclerosis (MS) •Missing limbs or partially missing limbs

•Post-traumatic stress disorder (PTSD) •Obsessive compulsive disorder •Impairments requiring the use of a wheelchair

•Intellectual disability (previously called mental retardation)

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

117 Route 303, Suite B • Tappan, NY 10983 • Tel: 845.398.3000 • Fax: 845.398.3001 • Hours of Operation: Monday - Friday 8:00 am - 4:30 pm

Terms and Conditions

Do Not Sell My Personal Information

Caribbean Food Delights

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