Jose Pepper's Employment Application Form

Name: *

First Name Last Name

Phone Number: *

Area Code Phone Number

E-mail Address:

Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

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 Time Part 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.) *

Yes No

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

Yes No

If yes, location and reason for leaving:

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

Yes No

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

Yes No

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 Cactus Grill?

Yes No

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

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

Signature Clear