Fields Marked With a * are Required
Personal Information
* Last Name
* First Name
* Present Address
* City
* State
* Zip Code
* Phone Number
* Email Address
Employment Desired
* Position Desired
Pick One
Barback
Bartender
Dishwasher
Hosting
Line Cook
Maintenence
Security
Server
Management
Sous Chef
* Date You Can Start
* Are You Employed Now?
Yes
* If So, May We Inquire of Your Present Employer?
Yes
* Are You Legally Authorized to Work in the US?
Yes
* Have You Ever Applied to or Worked for us Before?
Yes
Education History
* High School
* Years Attended
* Did You Graduate?
Yes
* Subjects Studied
Did You Graduate
Yes
General Information
Former Employers
* Name and Address of Most Recent Employer
* Start and End Date of Employment
* Salary
* Position
* Reason for Leaving
Start and End Date of Employment
Start and End Date of Employment
Start and End Date of Employment
References
* Name, Phone Number and Address of 1st Personal Reference
* Years Known
* How Do You Know Them?
* Name, Phone Number and Address of 2nd Personal Reference
* Years Known
* How Do You Know Them?
* Name, Phone Number and Address of 3rd Personal Reference
* Years Known
* How Do You Know Them?
Authorization
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
* Type Your Name Stating that You Understand the Authorization
* Todays Date
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