Job Application: Blue Moose Topeka

Title: Blue Moose Topeka

Fields marked with an asterisk (*) must be filled out before submitting.

Position applying for: * Server
Host/Hostess
Bartender
Cook
Dishwasher
Busser
Prep Cook
Doorman (O’Dowd’s only)
First Name: *
Last Name: *
Email Address: *
Address: *
City: *
State: *
ZIP: *
Phone Number: *
Date available to start work?: *
Type of employment desired: * full time
part time
temporary
 
Are you able to meet the attendance requirements?: * Yes
No
 
Do you have any objection to working overtime if necessary?: * Yes
No
 
Can you travel if required by this position?: * Yes
No
 
Have you ever been previously employed by our organization?: * Yes
No
 
If you are under 18, can you furnish a work permit if it is required? Yes
No
 
Have you ever been convicted of a crime in the last 7 years? * Yes
No
If yes, please explain (a conviction will not automatically bar employment)
 
Drivers license number (if driving is an essential job duty)
 
How were you referred to us?

Employment History

Please provide all employment information for your past four employers starting with the MOST RECENT, or attach resume.

Click here to attach and upload resume
May we contact your current employer? Yes
No
 
Employer #1:
Position held:
Address:
Telephone #
Immediate Supervisor and title:
Dates employed: From
To:
Salary/wage
Job Summary:
Reason for leaving:
 
Employer #2
Position held:
Address:
Telephone #
Immediate Supervisor and title:
Dates employed: From
To:
Salary/wage
Job Summary:
Reason for Leaving:
 
Employer #3
Position held:
Address:
Telephone #
Immediate Supervisor and title:
Dates employed: From
To:
Salary/wage:
Job Summary:
Reason for leaving:
 
Employer #4
Position held:
Address:
Telephone #
Immediate Supervisor and title:
Dates employed: From
To:
Salary/wage:
Job Summary:
Reason for leaving:
 

Other Skills and Qualifications

Summarize any job-related training, skills, licenses, certificates, and/or other qualifications:
 

Educational History

High School:
Location:
Years completed:
Degree earned: Yes
No
 
College:
Location:
Years completed:
Course of study:
Degrees earned:
 
Technical Training:
Location
Years completed:
Course of Study:
Degrees earned:
 
Other:
 

References

List 3 references, (do not include relatives or employers):

Reference #1 Name:
Years known:
Telephone #
 
Reference #2 Name:
Years known:
Telephone #
 
Reference #3 Name:
Years known:
Telephone #

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. 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. 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. 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. I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

 

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

Please select * I accept these terms
I do not accept these terms