Application - Blue Ridge Restaurant Group, LLC

Which location are you applying to? *

How did you hear about The Stanford Grill *

How did you hear about Copper Canyon Grill *

Which position are you applying for? *

Desired Start Date *

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Email

Confirm Email

Phone *

Emergency Contact Name *

Emergency Contact Number *

Are you under 18 years of age? *

yes
no

If "Yes" List Date of Birth *

Have you ever been employed by the Blueridge Restaurant Group? *

Yes
No

If "yes" please complete the following:

Name of Supervisor *

Location *

Employment Desired *

Full-Time
Part-Time

WHICH DAYS ARE YOU AVAILABLE TO WORK? *

select all that apply

HOURS AVAILABLE: MONDAY *

From-To

HOURS AVAILABLE: TUESDAY *

From-To

HOURS AVAILABLE: WEDNESDAY *

From-To

HOURS AVAILABLE: THURSDAY *

From-To

HOURS AVAILABLE: FRIDAY *

From-To

HOURS AVAILABLE: SATURDAY *

From-To

HOURS AVAILABLE: SUNDAY *

From-To

EDUCATION *

High School
College
Graduate School
Other

Select all that apply

EDUCATION: High School *

Name and address of school

Major *

Years Attended *

Did You Graduate? *

Yes
No

Degree Received *

Graduate School

Name and address of school

Major

Years Attended

Did You Graduate?

Yes
No

Degree Received

EDUCATION: College

Name and address of school

Major

Years Attended

Did You Graduate?

Yes
No

Degree Received

EDUCATION: Other

Name and address of school

Major

Years Attended

Did You Graduate?

Yes
No

Degree Received

EMPLOYMENT (1) *

(List most recent job first)

Company Address *

Job Title/Duties Performed *

Name of Supervisor *

Phone Number (Area Code) *

Example: (410)-222-2222

Start Date *

Month/year

End Date *

Month/Year

Starting Pay *

Ending Pay *

Reason For Leaving *

EMPLOYMENT (2)

Company Address

Job Title/Duties Performed

Name of Supervisor

Phone Number (Area Code)

Example: (410)-222-2222

Start Date

Month/year

End Date

Month/Year

Starting Pay

Ending Pay

Reason For Leaving

EMPLOYMENT (3)

Company Address

Job Title/Duties Performed

Name of Supervisor

Phone Number (Area Code)

Example: (410)-222-2222

Start Date

Month/year

End Date

Month/Year

Starting Pay

Ending Pay

Reason For Leaving

PERSONAL REFERENCES (1) *

Not former employers or relatives

Relationship or Title *

Phone Number *

PERSONAL REFERENCES (2) *

Not former employers or relatives

Relationship or Title *

Phone Number *

I certify that the above information is correct and understand falsification is grounds for dismissal. I authorize the references, supervisors, and educational institutions listed above to give you any information, personal or otherwise, concerning my prior employment or education. I authorize you to conduct a criminal conviction and credit check on me, and I release all parties from any liability resulting from furnishing this information to you. I understand and agree that Stanford Grill employment policies, manuals, and handbooks are not express or implied contracts and that these documents and the wages, benefits, and other terms and conditions of employment may be changed at Stanford Grill discretion from time to time without notice to me. I understand and agree that my employment with Stanford Grill may be terminated by me or Stanford Grill at any time for any reason without prior notice to the other party and that no written or oral Stanford Grill policy concerning continued employment constitutes or is intended to constitute an express or implied contract. I further understand and agree that, except for this application, there are not now and will not in the future be any express or implied contractual terms of employment between Stanford Grill and me. *

Yes

Electronic Signature (Required) *

Date *