South Side Mission

Last Name

First Name

Address

City, State, Zip

Phone Numbers

E-Mail Address

The Culinary Arts Training School is a 12 week full-time commitment.

Class is normally scheduled between the hours of 8:00 a.m. and 3:00 p.m.

Please indicate which session you are applying for:

Session Applying For

Spring: March-May

Fall: August-November

Winter: December-February

Are you a citizen of the United States?

Yes

Are you legally authorized to work in the United States?

Yes

Have you ever been convicted of a felony?

Yes

Please Explain:

Have you ever worked in the restaurant industry?

Yes

Please Explain:

EDUCATION

High School Name

High School Address

Did you Graduate?

Yes

College or other training

Please Explain:

REFERENCES

Who referred you to the Culinary Arts Training School? (Or, if no one referred you, how did you hear about us?)

Name

Relationship

How can we contact them?

CURRENT OR PREVIOUS EMPLOYMENT

Company

Phone Number

Address

Supervisor

May we contact them for a reference?

Yes

Job Title/Duties

Salary

Worked here when?

Reason for Leaving?

MILITARY SERVICE

Branch

Service Dates

Rank at Discharge

Type of discharge

DISABILITY HISTORY

Have you ever applied for disability?

Yes

Are you currently on disability?

HEALTH HISTORY

Do you have any medical or mental health concerns?

Hypertension?

Diabetes?

High Cholesterol?

Schizophrenia?

Bi-Polar Disorder

Post Tramatic Stress Disorder

Any other mental or emotional disorder?

Are you seeing a physician for these concerns?

Are you taking Prescription Medications for these concerns?

Any Addictions?

Drug of Choice

Clean and Sober Since ____?

ESSAY

Tell us...

DISCLAIMER AND ADDITIONAL INFORMATION

I understand that South Side Mission exists to preach the Good News of Jesus Christ, and in His name to love, house, feed, clothe and teach all those people who he sends to us.
I understand that the Culinary Arts Training School is a drug free environment. Drug testing (random and for cause) is a required component of this program.
I understand that completion of this application does not guarantee my admission into the program. If I am selected for consideration, I will be notified of an interview by phone.
I understand that upon admission, I will be subjected to a two week evaluation period. If determined to be unsuitable, my participation in the program will be terminated. The decision of the chef is final.
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to acceptance into the Culinary Arts Training Program, I understand that false or misleading information in my application or interview may result in my release.

I understand and agree with the above disclaimer and information.

Student Application

Culinary Arts Training School File Downloads