Jack Quinn's Online Employment Application

Name

Address

City / State / Zip

Telephone

2nd (Cell or other) Telephone

Email Address

Referred By

Previous Employer 1

Employment Dates

Reason for Leaving

Previous Employer 2

Employment Dates

Reason for Leaving

Previous Employer 3

Employment Dates

Reason for Leaving

Previous Employer 4

Employment Dates

Reason for Leaving

Most Recent
Employer's Phone

May We Contact?

Yes

Position(s) Desired

Management
Line Cook
Prep Cook
Dishwasher
Server
Host/Hostess
Bartender

Over 18?

Yes No | Social Security Number

Any Felony Conviction?

Yes No | If YES, date and State/County

If hired, can you provide evidence that you are authorized to work in the USA?

Yes No

U. S Military Service Branch

Rank and Type
Training/Experience

EDUCATION
NAME/LOCATION | COURSE OF STUDY | # YEARS COMPLETED | DEGREE

List Elementary
High School
College
Technical or Other

REFERENCES

Include Name, Occupation, Years Known and Contact Telephone Number for Each

How were you referred to Jack Quinn?

Any relatives employed by this organization? Specify.

No | Yes and Names

Is there any information we would need about your name, or use of another name, for us to check your work record?

Yes No

If yes, please specify

Comments:

Please list any additional information that relates to your ability to perform the job for which you have applied such as licenses, professional memberships, hobbies, etc.

APPLICANT'S STATEMENT

I understand that the employer follows an “employment at will” policy, in that I or the employer may terminate my employment at any time, or for any reason consistent with applicable state or federal law; this “employment at will” policy cannot be changed verbally or in writing, unless the change is specifically authorized in writing by the General Manager of the organization. I understand that this application is not a contract of employment, I understand that federal law prohibits the employment of unauthorized aliens; all persons hired must submit satisfactory proof of employment authorization and identity; failure to submit such proof will result in denial of employment.

I understand this application will be active for a period of one year; after that time, if I wish to be considered for employment, I must submit a new application.

I understand that the employer will thoroughly investigate my work and personal history and verify all data given on this application, on related papers, and in interviews. I authorize all individuals, schools, and firms named therein, except my current employer if so noted, to provide any information requested about me, and I release them from all liability for damage in providing this information.

I certify that all the statements herein are true and understand that any falsification or willful omissions shall be sufficient cause for dismissal or refusal of employment.

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