Employment Application

Fields marked with * are required fields and must be completed to submit the application.

How did you hear about the position?

Full Name *

Address *

City, State, Zip *

Phone *

Email Address *

Date Available

Salary Desired

Are you a Citizen of the United States? *

Yes

No

If No, are you authorized to work in the U.S.?

Yes

No

REFERENCES

Reference 1 Name

Relationship

Company

Phone Number

Reference 2 Name

Relationship

Company

Phone Number

PREVIOUS EMPLOYMENT>

Company 1

Address

Phone Number

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

Date Started

Date Left

Reason for Leaving?

May we contact your previous supervisor for a reference?

Yes

No

Company 2

Address

Phone Number

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

Date Started

Date Left

Reason for Leaving?

May we contact your previous supervisor for a reference?

Yes

No

Please explain any gaps in employment history

Have you ever been discharged or forced to resign? *

Yes

No

If yes, please explain

Have you ever been convicted of a felony? *

Yes

No

If yes, please expain

Have you ever been arrested or charged with any misdemeanor or felony not disclosed for which you are out on bail or free on your own recognizance pending disposition or trial? *

Yes

No

If yes, give the date(s) and details of the arrest or charge and any other circumstances you deem relevant to a full understanding of what occurred. NOTE: Answering “Yes” to this question is not an automatic bar to employment. We will consider whether the circumstances of the arrest substantially relate to the circumstances of the particular job sought, and any other consideration allowed by law. Please be advised that a misstatement or omission in answering this question may be grounds for disciplinary action, including discharge.

DRIVING RECORD

Do you have a valid driver’s license? *

Yes

No

I certify that my answers are true and complete to the best of my knowledge.

I understand that any misrepresentation, falsification or omission of this application shall be sufficient
reason for refusal to hire or, if discovered after employment has begun, dismissal of my employment. I
hereby authorize investigation of all matters contained in this application and agree that if results of
such investigation are not satisfactory, any offer of employment may be withdrawn, or, if applicable,
my employment may be terminated immediately. I agree to conform to and adhere to the rules and
regulations governing my employment. Further, I understand and agree that this application and any
other materials I may receive are not intended to be, nor shall be construed to be a contract of
employment, and that my employment and compensation may terminate, with or without cause, and
with or without notice, at any time, at the option of either myself or my employer.

Federal Law prohibits the company from hiring any person unless he/she presents documents which
establish identity and eligibility to work in the United States. Therefore, the company will require that
each new hire present such documents as a condition of employment.

The company does not discriminate in hiring or employment in accordance with requirements of all
applicable local, state, and federal laws, on the basis of race, color, creed, sex, national origin, age,
veteran status or physical or mental disability unrelated to job requirement.

You are neither asked nor required to disclose information about physical or mental disabilities.
However, if you wish the company to consider arranging a reasonable accommodation due to a
physical or mental disability, you may suggest the kind of accommodation you believe would be
appropriate for consideration.

The use, possession, sale or being under the influence of illegal drugs or alcohol while on company
time is prohibited.

Signature *By typing your name and hitting Submit, you are providing your signature digitally *

If you are human, leave this field blank.

Home – Contact – Gallery – 5 Reasons to Clean Your Grill