Chase Park Plaza Job Application

Personal Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Email*
example@example.com
Are you 21 years of age or older?*

YesNo
Are you legally authorized to work in the U.S.?*

YesNo
Have you ever been convicted of a crime(s)other than a minor traffic violation?*

YesNo
Please explain
*= Required
General
What position are you applying for?*

Assistant ManagerBartenderCrew Member
Are you able to work weekends?*

YesNo
If no, please explain:
Are you able to work holidays?*

YesNo
If no, please explain:
Are you at least 16 years of age?*

YesNo
If no, when will you be 16?
*= Required
REFERRAL INFORMATION
How were you referred to us?*

Walk-inEmployeeWebsite
If employee, please list their name
Have you ever worked for the company before?*

YesNoType option 3Type option 4
*= Required
EDUCATION AND TRAINING
Select the highest grade or year completed in school*

123456789101112
Do you have a High School Diploma, HSED, or GED?*

YesNo
Name of School
From Date /To Date
Course of study
Degree/Awards
Name of School
From Date /To Date
Course of study
Degree/Awards
Highest grade completed in college
If you are in High School, are you involved in any sports, drama, band etc.

YesNo
List what activities you are in
*= Required
Work History
Are you currently employed?*

YesNo
If yes, may we contact your current employer?

YesNo
This job will be my...*

Second JobOnly Job
Please list your last employer
Employer
From (Month/Year)
To (Month/Year)
City, State
Your Title(s)
Your Duties
Pay Rate
Reason for Leaving
*= Required
REFERENCES
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
How long have you known them?
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
How long have you known them?
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
How long have you known them?
*= Required
Authorization
IMPORTANT: READ THIS CAREFULLY BEFORE SUBMITTING THE APPLICATION
I certify that the answers given by me on this application are true, correct and complete. I agree that any misstatement or pertinent omission made by me in this application may be cause for my rejection, or if hired, may subsequently subject me to dismissal. Moreover, I understand that all offers of employment are conditioned upon passing the company’s prescribed drug test.

In the event of employment, I will comply with all company rules and regulations as may be established from time to time. Furthermore, since the company does not offer contracts of employment, I understand that nothing contained in this application form or any employee handbook is intended to create a contract between the company and me for either employment or the provision of any compensation or benefits. I understand that if employed, I have the right to terminate my employment at any time and likewise, the company has the same right.
Initial:*
Should be Empty:

Personal Information

General

REFERRAL INFORMATION

EDUCATION AND TRAINING

Work History

REFERENCES

Authorization