Employment Application « Country Barbeque

If you are a human and are seeing this field, please leave it blank.

Fields marked with a * are required

Personal Information

First Name *

Last Name *

Present Address *

City *

Zip *

Permanent Address (if different)

City

Zip

Phone *

Secondary Phone

Email *

Referred By

Employment Desired

Position *

Date you can start *

Salary Desired

Are you employed now? *

If yes, may we inquire of your present employer?

Are you legally authorized to work in the U.S.? *

Have you ever applied to Country BBQ before? *

If yes, where?

When

Have you ever worked for Country BBQ before? *

If yes, where?

Start Date

End date

Reason for leaving

Name of last Supervisor at Country BBQ

If 'website' or 'other,' please list.

Education History

High School Name & Location

Years Attended

Did you Graduate?

Subjects Studied

College Name & Location

Years Attended

Did you Graduate?

Degree/Subjects Studied

Trade, Business, or Correspondence School Name & Location

Years Attended

Did you Graduate?

Subjects Studied

General Information

Subject of Special Study/Research Work

Special Training, Certifications, Licenses

Special Skills, Foreign Languages, etc.

Military Service Record

Have you ever served in the U.S. Armed Forces? *

Branch of Service

Discharge Date

Rank

Former Employers

List last three employers starting with the most recent.

Name of Present or Last Employer

Address

City

Zip

Start Date

End Date

Job Title

Weekly Starting Salary

Weekly Final Salary

May we contact your Supervisor?

Supervisor Name

Supervisor's Title

Supervisor's Phone

Description of Work

Reason for Leaving

Name of Previous Employer

Address

City

Zip

Start Date

End Date

Job Title

Weekly Starting Salary

Weekly Final Salary

May we contact your Supervisor?

Supervisor Name

Supervisor's Title

Supervisor's Phone

Description of Work

Reason for Leaving

Name of Previous Employer

Address

City

Zip

Start Date

End Date

Job Title

Weekly Starting Salary

Weekly Final Salary

May we contact your Supervisor?

Supervisor Name

Supervisor's Title

Supervisor's Phone

Description of Work

Reason for Leaving

References

List professional references whom we may contact.

Reference Name

Address

City

Zip

Company Name

Phone

Reference Name

Address

City

Zip

Company Name

Phone

Reference Name

Address

City

Zip

Company Name

Phone

Authorization

I authorize the information in this form. *

By checking this box, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.