Application for Employment

An Equal Opportunity Employer

This employer participates in E-Verify

Instructions: Please enter all information and complete every part of this application. If there is a question which does not apply mark "N/A". Do not leave any question unanswered. Any false, misleading or incomplete responses may result in disqualification for hire or immediate dismissal from employment. This application will be kept on file for consideration for 30 days, at which time it will expire. You are welcome to submit a new application at that time. Please let us know if you are in need of any reasonable accommodation in the application process.

* Position applied for:

* Today's Date:

* Date you can start:

How did you learn about this job?

Personal Information

* First Name:

Middle Name:

* Last Name:

Other Name(s) Used:

* Email:

* Home Phone:

Other Phone:

* Address:

* City:

* State:

* Zip:

Are you available:

Please describe any work schedule limitations:

Have you applied for a job with us before?

If yes, state date:

Have you been employed by us before?

If yes, state date and jobs:

Do you have relatives employed by us?

If yes, the following relatives:

Have you ever been convicted of a felony, or any crime relating to theft or dishonesty, or involving acts of violence?

If yes, as follows:

NOTE: A criminal record will not necessarily disqualify an applicant from employment. The circumstances of the conviction will be considered in relation to the nature and duties of the job.

Are you authorized to be employed in the United States?

NOTE: The law requires that you provide evidence and a sworn statement of your citizenship or work authorization if you are hired. Any offer of employment which you receive is contingent upon your providing the documentation and statement which we will request from you.

Prior Employment

List your last three jobs, beginning with the most recent (you may omit jobs held more than five years ago).

May we contact your current employer?

Employer name/address/phone:

Job title:

Dates employed:

Duties:

Salary:

Reason for leaving:

Employer name/address/phone:

Job title:

Dates employed:

Duties:

Salary:

Reason for leaving:

Employer name/address/phone:

Job title:

Dates employed:

Duties:

Salary:

Reason for leaving:

Education & Training

Name and location of high school:

Graduated?

School/College

Level Complete

Degree

Major Subjects

Veteran Status

If you are a veteran of the armed forces of the United States, please provide the following information:

Military Branch:

Rank at Time of Discharge:

Training/Work Experience Received:

Other Skills

Describe any special skills including computer, tool, equipment, or office machine skills and proficiency level:

List all professional affiliation and/or licenses or certificated held which are relevant to the position applied for, including state, license or certificate type, date issues, and license or certificate number:

References

Please list three references whom we can contact.

Name:

Relationship:

Phone Number:

Occupation:

Years Known:

Name:

Relationship:

Phone Number:

Occupation:

Years Known:

Name:

Relationship:

Phone Number:

Occupation:

Years Known:

By signing below, I certify that the answers and information set out above are true, accurate and complete to the best of my knowledge. I acknowledge that if any answers or information is not true, accurate or complete, I may not be hired, or if hired, I may be discharged. I authorize The Alliance Group, Inc (Alliance)/Client Company, or its agents, to investigate all statements contained in this application for employment and to investigate my character or qualifications. I authorize my prior employers, references, and others information regarding my work or education history or my character, to provide Alliance/Client Company, or its agents, with all requested information and references, and to cooperate fully with the investigation of my character or qualifications.

I understand that this application is not a contract of employment. I also acknowledge that no oral representatives have been made and that no one within Alliance/Client Company has the authority to make oral contracts of employment. If hired, my employment relationship with alliance/Client COmpany is terminable at-will, with or without cause, by either myself or Alliance/Client Company.

I also understand that any offer of employment may be conditional upon my passing a pre-employment physical examination and drug/alcohol test administered by a health care professional selected by Alliance/Client Company to which I hereby consent.

I understand and agree to all of the conditions and statements set forth above, and throughout this application.

Applicant's Signature:

Date:

We are an equal opportunity employer, Employment opportunities are open to all qualified applicants solely on the basis of their job-related experience, knowledge, skills, and abilities. Qualified applicants are considered for all open positions for which they apply and for advancement without regard to race, color, religion, gender, sexual orientation, national origin, age, marital status, or the presence of a medical condition or disability. The Company complies with all applicable federal, state, and local laws with regard to equal employment opportunity. Advancement is based entirely on an individual's demonstrated performance, job-related ability, skills and knowledge and the resulting potential for promotion to the job openings applied for.

Minimum Age

To operate any mechanical equipment you must be 18 years of age or older. To work as a server you must be 19 years of age or older.

* Denotes Required Field

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