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APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer


Round One Entertainment, Inc. is an equal opportunity employer with a policy of hiring and promoting one the basis of qualifications, proven
ability and level of contribution without regard to race, color, religion, sex, sexual orientation, gender, physical condition, national origin,
marital status, veteran status, age, or any other basis protected by law.

I. APPLICANT INFORMATION
Last Name First Middle Initial Social Security Number


Present Address Street City State Zip Code


Home Phone No. Cellular Phone No. E-Mail Address
( ) ( )

Have you ever worked under a different name? If yes, please identify any other names you have used.

! Yes ! No _________________________________

If hired, can you provide verification of your legal right
to work in the United States?

! Yes ! No

Are you of legal age to dispense alcohol beverage in
California?
! Yes ! No

If you are under age 18, do you have a work permit?


! Yes ! No

How did you hear about us?
! Walk-in: ! Employee: __________________
! Advertisement: ________________________
If required for the position, do you have a drivers
license?

! Yes ! No
If hired, would you have reliable transportation to and
from work?

! Yes ! No
! Internet: ______________________________
! Other: _______________________________

Have you ever been convicted of a felony? ! Yes ! No If Yes, list Offense, Date and Disposition of the Case (convictions will not necessarily disqualify you for employment)



II. EMPLOYMENT INFORMATION
Position you are applying for:
!Food & Beverage !Facilities ! Bowling
!Amusement !Bartender

Wage/Salary Desired

$
Type of Employment Desired

! Full Time ! Part Time ! Temporary ! Other_________________

Have you ever applied for employment with the
Company
! Yes ! No
If so, please provide the dates and locations



Have you ever been employed by the Company?


! Yes ! No
If so, please provide the followings


_______________________________________________________________________________________________
Job Title Date Location Supervisor
Date Available Are you willing to travel?

! Yes ! No
Are you willing to relocate?

! Yes ! No
Would you be willing to work overtime?

! Yes ! No
Can you work flexible Hours?

! Yes ! No
Can you work weekends/holidays?

! Yes ! No
Days and Hours Available to Work

Sunday

______:______am/pm

Monday

______:______am/pm



Tuesday

______:______am/pm


Wednesday

______:______am/pm


Thursday

______:______am/pm



Friday

______:______am/pm




Saturday

______:______am/pm



III. MILITARY SERVICE
Have you ever been in the military?


! Yes ! No
If so, please list the followings

_________________________________________________________________
Date of Service Branch of Service MOS



Location: ___________________

Position
Applied For: ___________________

Interview Date: ___________________


Interviewer: ___________________


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IV. EDUCATION INFORMATION
School Level Name and City/State of School Course of Study
Circle Last Grade
Completed
Did you
graduate?
Degree or
Diploma
High School

1 2 3 4 ! Y ! N

College/University

1 2 3 4 ! Y ! N

Graduate School

1 2 3 4 ! Y ! N

Other Certification/
Relevant Training

1 2 3 4 ! Y ! N

Other Certification/
Relevant Training

1 2 3 4 ! Y ! N

Do you have any other experience, training, qualifications, or skills which you feel make you especially suited for work at the company? Is so, please explain.
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________

V. LANGUAGE
Foreign Languages (indicate proficiency to speak, read and write if directly job related)

1. ! Speak! Read ! Write 2. ! Speak! Read! Write 3. ! Speak! Read! Write




VI. EMPLOYMENT INFORMATION (Start with Current or Most Recent Employer)
List below all present and past employment starting with your most recent employer. Account for all periods of unemployment (you may exclude periods of
sickness or disability). Complete this section and/or attach resume.
Company Name Phone

Type of Business
Street Address City State Zip Supervisors Name

Position Title Reason for Leaving Starting Pay

$

Ending or Current Pay

$
Bonus

$
Duties


1
From (Mo./Yr.)


To (Mo./Yr.) May we contact this current employer?
! Yes ! No
Company Name Phone

Type of Business

Street Address City State Zip Supervisors Name

Position Title Reason for Leaving Starting Pay

$
Ending or Current
Pay

$
Bonus

$
Duties


2
From (Mo./Yr.)

To (Mo./Yr.)

Company Name Phone

Type of Business

Street Address City State Zip Supervisors Name


Position Title Reason for Leaving Starting Pay

$

Ending or Current Pay

$
Bonus

$
Duties


3
From (Mo./Yr.)

To (Mo./Yr.)


Please account for any time you were not employed in the last 10 years, after leaving school.

Time Period: Reason for Being Unemployed:


____________________________________________ _________________________________________________________________________________________________


____________________________________________ _________________________________________________________________________________________________

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___________________________________________ _________________________________________________________________________________________________
VII. PLEASE READ CAREFULLY, INITIAL EACH PARAGRAPH AND SIGN BELOW

____



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____


____





____


____

Truthful Application. I certify that all the information provided in this application is true and that I have not knowingly withheld any facts that might
affect the Companys decision to employ me. I am aware that any misrepresentation or omission on this application shall be sufficient cause for
rejection of this application or for immediate termination of employment if I am employed, regardless of the time elapsed before discovery.

Consent to Employment Verification. I hereby authorize Round One Entertainment, Inc. to thoroughly investigate my references, work record,
education and other matters related to my suitability for employment, and further authorize the references I have listed to disclose to Round One
Entertainment, Inc. any and all letters, reports, and other information related to my work records, without giving me prior notice of such disclosure. In
addition, I hereby release Round One Entertainment, Inc., my former employers and all other persons, corporations, partnerships and associations
from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

New Hire Orientation Period. I understand all new employees are on a 3 month new hire introductory period, after which suitability for regular
employment will be decided by the Company.

Employment-at-will Relationship. I understand that nothing contained in the application, or conveyed during any interview which may be granted or
during my employment, if hired, is intended to create an employment contract between me and Company. In addition, I understand and agree that if I
am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of
either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing
and signed by me and the Companys Executive Vice President/CFO or equivalent position.

Proof of Legal Right to Work in U.S. I understand that if I am hired, I will be required to provide proof of identity and proof that I may legally work
within the U.S.

Background Checking. I understand Round One Entertainment, Inc. will perform a background check on all applicants who receive employment
offers. All checks will be performed by a third-party and will be completed at the expense of the Company. I hereby certify that the entries
made on this employment application are true and correct. I agree to submit to a post-offer pre-employment substance and/or alcohol
examination.
PLEASE READ THE ABOVE STATEMENTS AND SIGN BELOW TO INDICATE YOUR AGREEMENT

Signature of Applicant: ________________________________________________ Date: ___________________________



REV: 09/2013