Jose Pepper's Employment Application Form

Name:*

First NameLast Name

Phone Number:*

Area CodePhone Number

E-mail Address:

Address:*

Street Address

CityState / Province

Postal / Zip Code

Location Applying To:

Position Applying For

We are an Equal Opportunity Employer and do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, or any other basis protected by law.

Type of Employment*

Full TimePart Time

If hired, can you provide evidence that you are legally able to work in the United States? (Proof of identity and legal authority to work in the United States is a condition of employment with Cactus Grill.)*

YesNo

Have you ever been employed by Jose Pepper's or Cactus Grill?*

YesNo

If yes, location and reason for leaving:

Are you of legal age to serve alcohol in this State? (Kansas legal age is 18)*

YesNo

Are you or do you plan to be in school or taking courses at any time while working for Jose Pepper's*

YesNo

Please fill out the boxes indicating which days you CAN work. *

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Lunch Shift
Dinner Shift

Do you presently have a job you intend on keeping if hired with our restaurant?

YesNo

Education

	Name of School	City/State	Dates Attended	Year Completed	Major Study	Degree Received
High School
Other School
College

Employment

	Current or Most Recent Job	Previous Job	Previous Job
Company Name/Location
Positions Held
Name and title of Immediate Supervisor
Dates of Employment
Reason for Leaving

I confirm that the information contained in this application is true, honest, and complete. I understand that false answers might be reasoning for Jose Pepper’s or Cactus Grill not hiring me, or for possible termination of employment at any point in the future if I am employed. I authorize the verification of all information above. I agree to follow the policies and procedures of the company, and I understand that if hired, my employment is considered “at will” and can be terminated at any time by me by the company with or without notice, for any reason.

I agree

Signature