Del Road, LLC. Employment Application

Employment Application
We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.
Check position all that you would like to be considered for

Line CookCashierDishwasherServerHost/HostessBusserFood RunnerPrep CookBartenderOther
Have you worked for us in the past?

YesNo
Name:*

First NameLast Name
Phone Number:*

Area CodePhone Number
E-mail Address:
Best method to contact you?

PhoneTextEmail
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How were you referred to us?*

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Can you, with or without accommodation, perform all of the essential functions of the job for which you are applying?*

YesNoOther
Job Skills & Training
Describe your skills:*
Training or Certifications:
Employment History
Company Name*
Supervisors Name*
Start of employment
Last day of employment
Last position held*
Reason for leaving*
Company Name*
Supervisors Name*
Start of employment
Last day of employment
Last position held*
Reason for leaving*
Company Name*
Supervisors Name*
Start of employment
Last day of employment
Last position held*
Reason for leaving*
I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.*

YesNo
I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that person’s need for a reasonable accommodation as required by the ADA*

YesNo
I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.*

YesNo
I understand employment with the Company is contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States. **

YesNo
If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law. **

YesNo
I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information. **

YesNo
I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.*

YesNo
I agree and understand that the company uses a system of mutual binding arbitration to resolve disputes. However, I understand I am not required to sign an arbitration agreement as a condition of employment **

YesNo
I agree and understand that the company uses a system of mutual binding arbitration to resolve disputes. **

YesNo
Date of Application
Please type your first and last name*
Signature- You can sign using a mouse or finger (You can use your finger only on touch screen)

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