Careers Choose The Location Where You Want To Apply Avondale, AZ Applications (Avondale, AZ) × Join The Avondale Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Chandler, AZ Applications (Chandler, AZ) × Join The Chandler Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Gilbert, AZ Applications (Gilbert, AZ) × Join The Gilbert Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Moab, UT Applications (Moab, UT) × Join The Moab Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Woodland Park, CO Applications (Woodland Park, CO) × Join The Woodland Park Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Cortez, CO Applications (Cortez, CO) × Join The Cortez Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Farmington, NM Applications (Farmington, NM) × Join The Farmington Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Las Vegas, NV Applications (Las Vegas, NV) × Join The Las Vegas Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Page, AZ Applications (Page, AZ) × Join The Page Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send Sedona, AZ Applications (Sedona, AZ) × Join The Sedona Team Position Sought Please Choose One: Assistant Manager Busser Chef Dishwasher General Manager Host or Hostess Line Cook Prep Cook Waiter or Waitress Date First Name Last Name Address (Street, City, State, Zip) Primary Phone Alternate Phone Email When Can Your Start Desired Wage/Salary Are You A U.S. Citizen Or Authorized To Work In THe U.S. Without Any Restriction? Yes No Have You Ever Been Convicted Of A Felony? Yes No If Yes, Please Describe Circumstances Have You Ever Been Involuntarily Terminated Or Asked To Resign From Any Position Of Employment? Yes No If Yes, Please Describe Circumstances If Selected For Employment, Will You Submit To A Pre-Employment Drug Screening Test? Yes No Education High School (Name, Location, Years Attended, Degree Received, Major) College (Name, Location, Years Attended, Degree Received, Major) Other (Training, Certifications or License Held) List Other Information Pertinent To The Employment You Are Seeking How Did You Hear About The Position? EMPLOYMENT (Most Recent First) 1. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 2. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 3. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving 4. Employer Job Title Prior Position With This Employer If Any Start Date End Date Address (Street, City, State, Zip) Phone Supervisor Starting Salary Ending Salary Duties Performed Reason For Leaving ACKNOWLEDGEMENT AND AUTHORIZATION I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as deemed necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period of time should inquire whether applications are being accepted at that time. I, hereby, understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Send
