Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Contact Phone Number
(###)
###
####
Email
Date Available
*
MM
DD
YYYY
Position Desired
*
Host
Bartender
Line Cook
Prep Cook
Dishwasher
Server
Manager
Dishwasher
Years of Experience in position chosen:
*
Less than a year
2 to 5 years
5 or more years
Are you at least 18 years of age?
*
Yes
No
Are you a citizen of the U.S.?
*
Yes
No
If no, are you currently authorized to work in the U.S.?
*
Yes
No
If hired, can you provide proof that you are eligible to work?
*
Yes
No
If using a visa to show proof of eligibility, what is the Effective Date?
MM
DD
YYYY
Visa Expiration Date?
MM
DD
YYYY
Have you ever worked for us before or for our sister restaurant Barking Frog Grille?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
Do you have a current Food Handlers Permit and/or Alcohol Serving Permit
*
Yes, I have a Food Handlers Permit
Yes, I have a Alcohol Serving Permit
Yes, I have both permits
No, I do not have either permit
Employer 1:
*
Employer's Phone Number:
*
(###)
###
####
City/State:
*
Supervisor:
*
Job Title:
*
Main Duties:
*
Reason for Leaving:
*
Employer 2:
Employer's Phone Number:
(###)
###
####
City/State:
Supervisor:
Job Title:
Main Duties:
Reason for Leaving:
Employer 3:
Employer's Phone Number:
(###)
###
####
City/State:
Supervisor:
Job Title:
Main Duties:
Reason for Leaving:
High School:
City/State:
Did you graduate?
Yes
No
College or Trade School:
City/State:
Did you graduate?
Yes
No
Full Name:
Company:
City/State:
Phone Number:
(###)
###
####
Full Name:
Company:
City/State:
Phone Number:
(###)
###
####
Optional:
Applicant Agreement (Read Carefully Before Signing)
*
All information provided by me is true and correct to the best of my knowledge. I understand omissions or
misrepresentations may result in rejection of my application or, if employed, may result in subsequent dismissal. I hereby authorize any former employer, person, school, firm or corporation listed hereon, including this company, to answer any and all questions related to employment and agree to release from liability and hold all persons harmless for giving any and all truthful information within their knowledge or records. I understand this is a preliminary application and not a contract to employ me. Furthermore, in the event I am employed, my employment shall be completely voluntary and may be terminated “at will” at any time by either myself or the company. I understand that no one other than the company owner has authority to enter into any employment agreement to the contrary. I agree to comply with all rules of the company as a condition of employment.
Applicant Signature (Type Your Full Name):
*
Today's Date:
*
MM
DD
YYYY
