Poblano Grill Employment Application

Poblano Grill Employment Application - An Equal Opportunity Employer

We look forward to adding new team members daily. Poblano Grill looks for excited, hard-working individuals who are willing to learn and are eager to become part of our family. Please complete application and submit. back to main

GENERAL

January 07, 2009


Last Name	M. I.	First Name	Social Security Number


Present Address	City	State	Zipcode

Birthdate (If under 21), 19

Primary Phone

Are you able to legally be employed in the
United States of America? Yes No

(Proof of identity and legal authority to work in the U.S. is a condition of employment.)

Position to apply

Desired Salary

Who referred you to Poblano Grill?

Available starting date

Availability	Sun	Mon	Tue	Wed	Thu	Fri	Sat
Days
Evenings

Have you ever been convicted of a felony? Yes No

If so, explain.

(Convictions will not necessarily exclude you from employment, but date and type of conviction may be considered for job placement.)

Relatives employed by Poblano Grill:


Name	Location	Relationship

EDUCATION

Type of school	Name of School	Location of School	Courses Majored In	Years Completed	Diploma
High School					Yes No
College					Yes No
Other					Yes No

Are you TABC certified?
Yes No

Expiration Date

Are you Food Handler certified?
Yes No

Expiration Date

VOLUNTEER AND MILITARY EXPERIENCE

Volunteer Experience

Skills Acquired

Military Experience

Skill Acquired

BUSINESS EXPERIENCE - List most recent first


Past Employer 1	Phone Number			From		To


Address	City	State	Zipcode


Position	Salary	Reason for leaving


Past Employer 1	Phone Number			From		To


Address	City	State	Zipcode


Position	Salary	Reason for leaving


Past Employer 1	Phone Number			From		To


Address	City	State	Zipcode


Position	Salary	Reason for leaving

I AFFIRM THAT ALL INFORMATION IN THIS APPLICATION IS TRUE AND COMPLETE. ANY MISREPRESENTATION, FALSE STATEMENT, OR OMISSION OF FACTS CALLED FOR SHALL BE CAUSE FOR DISMISSAL OR GROUNDS FOR REFUSAL OF EMPLOYMENT. I UNDERSTAND THAT ANY VIOLATION OF COMPANY RULES, POLICIES, STANDARDS, AND/OR PROCEDURES SHALL BE GROUNDS FOR DISMISSAL. I AGREE TO CONFORM TO THE RULES, POLICIES, STANDARDS AND REGULATIONS OF POBLANO GRILL, L.L.C. I UNDERSTAND THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME AT THE OPTION OF POBLANO GRILL, L.L.C. OR MYSELF, AND I UNDERSTAND THAT NO REPRESENTATIVE OF THE COMPANY HAS THE AUTHORITY TO MAKE ANY MODIFICATIONS, EITHER VERBALLY OR IN WRITING TO THE CONTRARY.

IT IS THE POLICY OF POBLANO GRILL, L.L.C TO HIRE ONLY U.S. CITIZENS AND ALIENS WHO ARE LAWFULLY AUTHORIZED TO WORK IN THE UNITED STATES. ALL EMPLOYEES WILL BE ASKED TO VERIFY EMPLOYMENT ELEGIBILITY PRIOR TO BEGINNING WORK.

Submitting this form will act as electronic signature.