Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

If hired, when would you be available to start?

MM

DD

YYYY

Type of employment desired:

Full Time

Part Time

Temporary

Immediate Supervisor

First Name

Last Name

May we contact this employer?

Yes

No

Immediate Supervisor

First Name

Last Name

May we contact this employer?

Yes

No

Completed:

Diploma

GED

Phone

(###)

###

####

Phone

(###)

###

####

I certify that all information I have provided in order to apply for and secure work with Farwood Bar & Grill, Inc. is true, complete, and correct. I expressly authorize the human resources department to contact and obtain information from all references, employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me on this application, resume, or interview. I hereby waive any and all rights and claims I may have regarding Farwood Bar & Grill, Inc. for seeking, gathering, and using truthful and non-defamatory information, in a lawful manne, in the employment process an all other persons, corporations, or organizations for furnishing such information about me. I understand that if I am hired, I will be required to provide proof of ID and legal authorization to work in the USA. I understand that any information provided that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to eliminate consideration for employment or may result in termination upon discovery.

Check below to certify that you have read, fully understand, and accept all terms of the foregoing Applicant Statement:

I read, understand, and accept all terms