Employment Application


Applicant Name:
Date:
Position Applied For:
Address:
Address Line 2:
Home Phone:
Mobile Phone:
E-mail:
Date Available:
Type of Employment:
full-time part-time temporary
Are there any days or
hours you cannot work?
Do you have any objection to
working overtime if necessary?
yes no
Can you submit proof of legal
employment authorization and identity?
yes no
Education (last grade completed):
List any coursework relevant to the desired job:

Provide all employment information for your past 4 employers starting with the most recent

Employer:
Position held:
Address:
Telephone number:
Immediate supervisor and title:
Dates employed from:
Dates employed to:
Reason for leaving:
Employer:
Position held:
Address:
Telephone number:
Immediate supervisor and title:
Dates employed from:
Dates employed to:
Reason for leaving:
Employer:
Position held:
Address:
Telephone number:
Immediate supervisor and title:
Dates employed from:
Dates employed to:
Reason for leaving:
Employer:
Position held:
Address:
Telephone number:
Immediate supervisor and title:
Dates employed from:
Dates employed to:
Salary:
Reason for leaving:
List 3 references names, telephone numbers, and
years known (do not include relatives or employers):
Name 1:
Phone Number 1:
Name 2:
Phone Number 2:
Name 3:
Phone Number 3:

I hereby authorize Three B's Bar & Bistro to contact, obtain, and verify the accuracy of information from all previous employers, educational institutions, and references contained in this application. I also hereby release from liability the Three B's Bar & Bistro and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the Three B's Bar & Bistro can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

Three B's Bar & Bistro is an Equal Opportunity Employer. It is the policy of Three B's Bar & Bistro to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity or expression, national origin, disability, protected Veteran status, or any other legally protected class or status recognized by federal, state or local law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.