Bender's Tavern Employment Application Bender's Tavern is an equal opportunity employer. All qualified applicants will be considered without regard to race, religion, creed, color, sex, national origin, age, handicap or ancestry as required by law.PERSONAL INFORMATIONApplication Date* Date Format: MM slash DD slash YYYY Name* First Middle Last Present Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Permanent Address (if different than above) Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone Number*Email Address* Are you 18 years of age or older?*YesNoIf no, what is your date of birth? Date Format: MM slash DD slash YYYY Are you legally entitled to hold employment in the United States?*YesNoHave you ever been convicted of a felony or misdemeanor which has not been expunged from your record, other than minor traffic violations?*YesNoIf "yes," where and for what offense(s) were you convicted?A conviction will not necessarily be a bar to employment. Factors such as date, nature and number of offenses, age at the time of the offense and rehabilitation, as well as job duties, will be considered.Have you ever been fired, discharged, or asked to resign from a job?*YesNoIf "yes," identify the former employer(s) by name, address, and telephone number. Explain the circumstances and provide the date(s).EMPLOYMENT DESIREDPosition*Salary Desired*Date You Can Start* Date Format: MM slash DD slash YYYY AVAILABILITYIndicate which days you can work by entering the earliest starting time and latest ending time.Start TimeMonTueWedThurFriSatSunEnd TimeMonTueWedThurFriSatSunEDUCATION*Degree of educational achievement is considered in the hiring process only to the extent that educational achievement is a requirement for performing the job.High School Name and Location Subjects studied / degree received Years Attended Did you graduate? College Name and Location Subjects studied / degree received Years Attended Did you graduate? Trade School Name and Location Subjects studied / degree received Years Attended Did you graduate? EMPLOYMENT EXPERIENCEList below present and past employment, beginning with your most recent (or current) employer.Are you employed now?*YesNoIf so, may we contact your present employer?*YesNoEmployer 1 AddressName & Address of Employer #1Date FromToEmployer 1 PositionPositionReason for leavingSalary upon leavingEmployer 2 AddressName & Address of Employer #2Date FromToEmployer 2 PositionPositionReason for leavingSalary upon leavingEmployer 3 AddressName & Address of Employer #3Date FromToEmployer 3 PositionPositionReason for leavingSalary upon leavingEmployer 4 AddressName & Address of Employer #4Date FromToEmployer 4 PositionPositionReason for leavingSalary upon leavingWork Experience*BookkeeperBus PersonCarverChefCookCook HelperCounterCashierDietitianDishwasherFood Prep TechnicianFountainHost or HostessKitchen HelperManagerPantryPastry CookPorterPot WasherSaladSandwichesTypistVegetable CookWait StaffWait Staff (arm service)Wait Staff (tray service)To select more than one, hold down the "Control" key and click on your selections.REFERENCESGive the names of three persons not related to you, whom you have known for at least one year.Reference #1NamePhone NumberEmail AddressTitle/CompanyYears AcquaintedReference #2NamePhone NumberEmail AddressTitle/CompanyYears AcquaintedReference #3NamePhone NumberEmail AddressTitle/CompanyYears AcquaintedAPPLICATION TERMS & SUBMISSIONIf assistance is needed during any phase of the hiring or employment process, please advise. I certify that the facts contained in this application are true and complete to the est of my knowledge and understand that if employed, incomplete, false or misleading statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I release all parties from all liability for any damage that may result from furnishing the same to you. I also authorize you to obtain information regarding my record with the Bureau of Motor Vehicles if the job for which I am applying will require driving as part of my job duties. I understand that pursuant to the company's job application process I may be required to undergo drug testing. I understand that I may be disqualified from further employment consideration if I refuse to take or fail the drug test, unless I can demonstrate that a) the test was erroneous; or b) prior to taking the test I ceased using illegal drugs and am now enrolled in a supervised rehabilitation program; or c) I am taking the drugs under supervision of a licensed health care professional. I knowingly and voluntarily consent to the company's request to undergo a drug test. I further release this company, its agents, representatives and employees from any and all claims and liability for damages associated with or arising from my submission to the test. In consideration of my employment, I agree to conform to the company rules, regulations and policies, and agree that my employment is at-will and that my employment and compensation can be terminated with or without cause, and with or without notice, at any time at the option of either the company or me. I understand that the rules and regulations and any personnel manual do not constitute a contract of employment.Accept terms outlined above*Yes, I accept the employment application termsApplication Submitted By* This iframe contains the logic required to handle Ajax powered Gravity Forms.