Employment - Farmhouse Grill at Racoon Creek

Name *

First

Last

Position(s) applied for

Date of application

Social Security

Address

Address Line 1

City

State

Zip Code

Telephone

Cell/Other Phone

E-mail Address

If you are under 18, and it is required, can you furnish a work permit

If no, please explain

Have you ever been employed here before?

If yes, give dates and positions

Are you legally eligible for employment in this country?

Date available for work

What is your desired salary range?

Numbers

Are you able to meet the attendance requirements of the position?

Have you ever pled "guilty" or "no contest" to, or been convicted of a crime?

If yes, please provide date(s) and details.

Answering"Yes" to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature Of the violation, rehabilitation and position applied for will be taken into account.

Date

Details

Driver's License number if driving is an essential job

State

EMPLOYMENT HISTORY

Provide the following information of your past three (3) employers, assignments or volunteer activities, starting with the most recent. When submitting a resume, please complete the application in full also.

1.

FROM

EMPLOYER

TELEPHONE

Starting Job Title/Final Job Title

Address

Address Line 1

City

State

Zip Code

Immediate Supervisor and Title

Summarize the nature of work performed and job responsibilities

May we contact for reference?

Yes
No
Later

Reason for leaving

Hourly rate/salary

Start$ / Per

Final $ / Per

2.

FROM

EMPLOYER

TELEPHONE

Starting Job Title/Final Job Title

Address

Address Line 1

City

State

Zip Code

Immediate Supervisor and Title

Summarize the nature of work performed and job responsibilities

May we contact for reference?

Yes
No
Later

Reason for leaving

Hourly rate/salary

Start$ / Per

Final $ / Per

3.

FROM

EMPLOYER

TELEPHONE

Starting Job Title/Final Job Title

Address

Address Line 1

City

State

Zip Code

Immediate Supervisor and Title

Summarize the nature of work performed and job responsibilities

May we contact for reference?

Yes
No
Later

Reason for leaving

Hourly rate/salary

Start$ / Per

Final $ / Per

SKILLS AND QUALIFICATIONS

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.

EDUCATION BACKGROUND (IF JOB RELATED)

High School

Name and Location

Number of years completed

Did you Graduate

Course of Study

College

Name and Location

Number of years completed

Did you Graduate

Course of Study

Other

Name and Location

Number of years completed

Did you Graduate

Course of Study

REFERENCES

Name

Telephone

Number of Years Known

APPLICANT STATEMENT *

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employers, its agents, employees or representatives, for seeking gathering and using such information in the employment process and all other person, corporations or organizations for furnishing such information about me. I understand that a background check will be done if I am considered for employment. I understand that the employer does not unlawfully discriminate in employment and no questions on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specifi4ed period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an 1-9 form in this regard. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT I CERTIFY THAT I HAVE READ, FULLY UNDERSTAND AND ACCEPT ALL TERM S OF THE FOREGOING APPLICANT STATEMENT.

Signature of Applicant *

Clear Signature

Signature of Date *

Download Application

What is your desired salary range?

If yes, please provide date(s) and details.

EMPLOYMENT HISTORY

1.

Hourly rate/salary

2.

Hourly rate/salary

3.

Hourly rate/salary

SKILLS AND QUALIFICATIONS

EDUCATION BACKGROUND (IF JOB RELATED)

High School

College

Other

REFERENCES

Contact Info

Hours of Operation