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First Name* Middle Initial* Last Name* Phone* Email* Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip
Referred by AdvertisementAgencyPersonIn Store SignageWebsiteOther Please Name Source (if answered other) Are you legally eligible for employment in the USA? Yes No Date of Birth* Position applying for Salary expected Do you have transportation to and from work? Yes No
Were you previously employed by us Yes No If yes, when Other name(s) used while attending schools or places of employment indicated on this form
Can you perform the functions of this job with or without reasonable accommodations Yes No If No, please explain Have you ever been convicted of a felony Yes No If yes, please explain (A conviction alone will not automatically bar you from employment)
High School
Name and Location Course of Study Currently Enrolled Yes No What year did you / do you plan to graduate
College
Name and Location Course of Study Currently Enrolled Yes No What year did you / do you plan to graduate Degree
Other
Military
Military Service Yes No Brach of service and rank Dates of Service Special Training
Current / Most Recent Employer
Name of Company Address Supervisor Salary Phone Job Title Date Started Date Left Job Description Reason for Leaving ---Still ThereLayed OffQuitFired Explain
Second Most Recent Employer
Third Most Recent Employer
First Reference
Name Relationship to Reference Occupation Address Phone
Second Reference
Third Reference
Please summarize any additional information necessary to fully describe your qualifications.
PLEASE READ All information written on this application is complete and accurate to the best of my knowledge. I understand that any misrepresentation of facts in this application disqualifies me from further consideration - or if employed - is grounds for dismissal. I understand that any employment offer is contingent upon satisfactory references and I authorize Fox Harbor Pub and Grill to investigate past employment and education history, as well as references given on application.
I understand that if employed such employment may be terminated for just cause, or no cause, by management at any time. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its management, and then only when in writing and signed by the management, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.
I fully understand and agree to all statements above.