Personal Information
Full Name:
Present Address:
City, State, Zip:
Permanent Address:
City, State, Zip:
Phone Number:
Cell or Alternate Phone Number:
Email:
Have you ever worked
under another name ?
Yes
No
If yes, list:
Position Desired:
Salary Expected:
I can work:
Full Time
Part Time
Temporary
Permanent
Days Available:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Times Available:
Days
Evenings
Nights
Overtime
Split Shifts
Any Time
Employment Record
Record your most recent position first. Failure
to accurately account for all periods during the last seven years
may lead to your application not being considered. If omissions
or falsifications are discovered subsequent to your employment,
such omissions or falsification will be sufficient cause for discharge
(List periods of school as follows: School name under company
name & dates attended.)
Have you ever worked for the Scarlet Oak Tavern before?
Yes
No
If yes, when?
Have you ever applied to the Scarlet Oak Tavern before?
Yes
No
Employer #1 (most recent)
Company Name:
Company Address:
Company City, State, ZIP:
Supervisor Name:
Phone Number:
Job Titles & Duties:
Reason for Leaving:
Starting Date:
Ending:
Starting Wage:
Ending:
Were you unemployed between positions?
Yes
No
Employer #2
Company Name:
Company Address:
Company City, State, ZIP:
Supervisor Name:
Phone Number:
Job Titles & Duties:
Reason for Leaving:
Starting Date:
Ending:
Starting Wage:
Ending:
Were you unemployed between positions?
Yes
No
Employer #3
Company Name:
Company Address:
Company City, State, ZIP:
Supervisor Name:
Phone Number:
Job Titles & Duties:
Reason for Leaving:
Starting Date:
Ending:
Starting Wage:
Ending:
Were you unemployed between positions?
Yes
No
Our Concern
May we contact your previous employers?
Yes
No
Please list any previous employers
you wish us not to contact:
Educational Record
Years Completed: Select
Select
Less than 8
8 to 12
13
14
15
16
More than 16
1. High School Name:
Degree Received:
Course Work:
2. Trade School Name:
Degree Received:
Course Work:
3. College Name:
Degree Received:
Course Work:
Other Information
Outside Activities or Hobbies:
If you have any friends or relatives
currently working at the Scarlet Oak Tavern, please list their
names and their relationship to you:
Are you older than 18?
Yes
No
Do you have reliable transportation
to get to and from work?
Yes
No
Military Service
Are you now, or have you ever been
in the military?
Yes
No
If yes, list branch of service and
highest rank attained:
If in reserves, are you currently
active?
Yes
No
Immigration Status
Are you legally eligible to work in the U.S.?
Yes
No
References
Name 1 :
Title:
Phone:
Years Known:
Name 2 :
Title:
Phone:
Years Known:
Name 3 :
Title:
Phone:
Years Known:
Important! Please Read Carefully
I hereby authorize investigation of all statements
contained in this application, including inquiry of any and all
of my former employers or references as indicated elsewhere on
this application, and hold said former employers and/or references
harmless from liability arising therefrom. I affirm that all the
information contained in this application is true and correct,
and that any misrepresentation, falsification or omission herein
shall be sufficient reason for dismissal from, or refusal for
employment. If employed, I understand that the company reserves
the right to modify or terminate my employment at any time, with
or without cause, and without prior notice. I further understand
that the duration, hours, nature, compensation and benefits of
my employment may be changed or modified from time to time without
limitation or condition. I understand that no representative of
the company has any authority to make any assertions to the contrary.
I hereby agree to abide by all policies and rules of this company
which govern dress, hair, grooming and attitude.
By clicking the Send Button, below, I acknowledge that I have
read, understood, and voluntarily agree to the above.
Name
(used as electronic signature):
Today's Date:
Please type the word you see:
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