Captain Amrinder Singh Job Form – Fill Out and Use This PDF

Essential Job Functions

All positions require working alone or in a group unless otherwise noted.

Circle position applying for:

Kitchen

Visual, some auditory, hand dexterity, full body mobility, coordination, must have the ability to: follow instructions; lift up to 50 lbs.; stand freezer temperatures for short periods of time; lift arms at shoulder height or above; work around heat and grease; stand on feet 100% of the scheduled work day; must have hand/eye coordination; work with hands in different types of food; be trained in good sanitary work habits.

Counter

Visual, some auditory, hand dexterity, full body mobility, coordination, must have the ability to: follow instructions and to make customers feel welcome; be trained in operating computer cash registers; carry and serve items such as tea and hot coffee; clearly call out customer ticket numbers; be trained in counter procedures; communicate with customer clearly; lift up to 50 lbs.; lift arms at shoulder height or above; stand on feet 100% of the scheduled work day; must have hand/eye coordination; work with hands in different types of food; be trained in good sanitary work habits.

Shift Leader, Supervisor of Managerial

Visual, some auditory, hand dexterity, full body mobility, coordination, must have the ability to: follow instructions; lift up to 50 lbs.; stand freezer temperatures for short periods of time; lift arms at shoulder height or above; work around heat and grease; must have the ability to: follow instructions and to make customers feel welcome; be trained in operating computer cash registers; carry and serve items such as tea and hot coffee; clearly call out customer ticket numbers; be trained in counter procedures; communicate with others clearly; stand on feet 100% of the scheduled work day; must have hand/eye coordination; work with hands in different types of food; be trained in good sanitary work habits; communicate over a telephone; use a calculator; be a minimum of 18 years old.

“Some Auditory” means the ability to hear orders and requests made by customers or co-workers. “Full body mobility” means the ability to walk, stand, bend, twist and reach.

Are you able to perform the essential functions of the position checked, with or without an accommodation?

	YES NO (circle one)
Signature		Date
	CONSENT TO THE DISCLOSURE OF YOUR INFORMATION
	Please read carefully and sign the statement below

Pursuant to Captain D’s policy, I hereby grant permission to Captain D's to investigate my employment, educational and personal background and character references. I release all persons who furnish such information to Captain D's from all liability and damages. I acknowledge and understand that I hereby received notice in compliance with the Fair Credit Reporting Act that Captain D’s may seek to procure a consumer report regarding my credit worthiness, credit history, credit capacity, character, general reputation, personal characteristics or mode of living from a consumer reporting agency. I understand that upon written request Captain D's shall make a complete and accurate disclosure of the nature and scope of this investigation, if one is made. I also understand that if my employment is denied because of such a report, I can submit a written request to obtain the name and address of the agency supplying the report. As allowed by law, I also agree to submit to random drug tests and other investigative interviews, methods or tests conducted by Captain D's and I understand that the results of such tests may be used as evidence in a legal or administrative proceeding and may also be used in considering my status for continued employment and as a basis for rejecting my application or terminating my employment.

I hereby authorize persons, school, businesses, current and previous employers and organization to provide any and all information that any of them may possess concerning or relating to me and that may be required for any employment decisions by Captain D's. A photocopy of this form may be used, if required for purposes of establishing authorization to disclose information about me.

I also understand that giving false or incomplete information on my application is grounds for termination and forfeiture of related benefits.

Upon acceptance of employment with Captain D's, I agree to follow all the policies, procedures, rules and regulations of Captain D's. I understand that I can leave Captain D's with or without notice and with or without cause and Captain D's reserves the same rights. I understand that nothing contained in this application, any manual, brochures, or other Captain D's materials shall constitute a contract or an implied contract of employment. In consideration of my employment, I understand that Captain D's and it’s affiliates have adopted a policy requiring good faith mediation of claims arising out of or related to my employment with Captain D's. Thereafter, any remaining unresolved claims shall be settled by arbitration.

I also agree to full release of liability to Captain D's for providing references to all potential employers in the event of my termination.

I certify that the information provided in this application is true and complete and is subject to confirmation by Captain D's.

I understand that the information contained herein is to be used in a confidential manner.

Applicant’s signature		Date
	APPLICANT STOPS HERE.

05/11/05 page 2