303 Three Springs Drive - Weirton, WV 26062

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Garden Grill Steakhouse Job Application Form - Online

Instructions: Print clearly in black or blue ink. Answer all questions. Sign and date the form.

Personal Information

First Name: ____________________ Middle Initial: ___ Last Name: _____________________________

Street Address: __________________________ City, State, Zip Code: _____________________

Phone Number: (___)_____________________ Email Address: __________________________

Have you ever applied to / worked for [Our Company] before? [ ] Y or [ ] N

If yes, please explain (include date): ________________________

Do you have any friends, relatives, or acquaintances working for [Our Company]? [ ] Y or [ ] N

If yes, state name & relationship: ________________________________

If hired, would you have transportation to/from work? [ ] Y or [ ] N

Are you over the age of 18? [ ] Y or [ ] N

If you are under the age of 18, do you have an employment/age certificate? [ ] Y or [ ] N

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States? [ ] Y or [ ] N

Have you been convicted of or pleaded no contest to a felony within the last five years? [ ] Y or [ ] N

If yes, please describe the crime - state the nature of the crime(s), when and where convicted, and the disposition (final settlement) of the case: ________________________________________________________________

If hired, are you willing to submit to a controlled substance test? [ ] Y or [ ] N

Position and Availability

Position Applying For: ___________________________

If kitchen position, do you have a current Safe Food Handler License? [ ] Y or [ ] N

If bar or lounge staff, are you at least 21 years old? [ ] Y or [ ] N

Desired Salary: $________

Are you applying for:

• Temporary work – such as summer or holiday work? [ ] Y or [ ] N

• Regular part-time work? [ ] Y or [ ] N

• Regular full-time work? [ ] Y or [ ] N

If applying for temporary work, indicate your desired length of employment below:

Start date: ___ / ___ / ___ End date: ____ / ____ / ____

Days Available- check all that apply

Monday ____ Tuesday ____ Wednesday ____ Thursday ____ Friday ____ Saturday ____ Sunday ____

Hours Available: from _______ to ______

Are you available to work overtime? [ ] Y or [ ] N

If hired, on what date can you start working? ___ / ___ / ___

Are you able to perform the essential functions of the job for which you are applying, either with / without reasonable accommodation? [ ] Y or [ ] N

If no, describe the functions that cannot be performed:

_____________________________________________________________

Education, Training and Experience

High School:

School Name: ________________________

School Address:________________________

School City, State, Zip:________________________________

Number of years completed: _______________

Did you graduate? [ ] Y or [ ] N

College / University:

School Name: __________________________

School Address:________________________

School City, State, Zip:________________________________

Number of years completed: ________

Did you graduate? [ ] Y or [ ] N

Degree / Diploma Earned: __________________

Military:

Branch: ______________________________

Rank in Military:________________________

Total Years of Service: ________

Skills/Duties: __________________________________

Related Details:________________________________

Skills and Qualifications: Licenses, Skills, Training, Awards: ________________________________

_____________________________________________________________________________________

Do you speak, write or understand any foreign languages? [ ] Y or [ ] N

If yes, list which languages(s) and how fluent you consider yourself to be: ____________________

Employment History

Are you currently employed? [ ] Y or [ ] N

If you are currently employed, may we contact your current employer? [ ] Y or [ ] N

Name of Employer:_____________________________________

Name of Supervisor:____________________________________

Telephone Number:_____________________________________

Business Type:________________________________________

Address:_____________________________________________

City, State, Zip:________________________________________

Length of Employment (Include Dates): _____________

Salary/Hourly Rate of Pay: ____________

Position & Duties: _______________________________________________________

Reason for Leaving: _____________________________________________________

May we contact this employer for references? [ ] Y or [ ] N

Name of Employer:_____________________________________

Name of Supervisor:____________________________________

Telephone Number:_____________________________________

Business Type:________________________________________

Address:_____________________________________________

City, State, Zip:________________________________________

Length of Employment (Include Dates): _____________

Position & Duties: _______________________________________________________

Reason for Leaving: _____________________________________________________

May we contact this employer for references? [ ] Y or [ ] N

References -List below two persons who have knowledge of your work performance within the last four years. Please include work related references only.

First and Last Name: ____________________________ Telephone Number:_______________________

Email Address: ________________________________ Number of Years Acquainted: _______________

First and Last Name: ____________________________ Telephone Number:_______________________

Email Address: ________________________________ Number of Years Acquainted: _______________

Certification

I certify that the information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment if I am hired. I authorize the verification of any and all information listed above.

Signature: ______________________________ Date: ______________