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EMPLOYMENT APPLICATION
Q Bar Channahon Employment Application
Employment Application Channahon
Employment information application for Q Bar Channahon
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Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Home / Mobile Phone
*
Email
*
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
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Wisconsin
Wyoming
State
Zip Code
Are you a U.S. Citizen or alien authorized to work in the United States?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
EMPLOYMENT DESIRED
(MUST BE 21 YEARS OLD TO BARTEND AND 18 YEARS OLD TO SERVE)
Positions
*
Date you can start
Are you interested in working at one of our other locations if we have no current openings at this one?
*
Yes
No
Are you Basset certified in DuPage County?
*
Yes
No
Do you have a food handlers permit?
*
Yes
No
Are you currently employed?
*
Yes
No
If Yes may we contact your current employer?
Yes
No
Have you ever applied to this company before?
Yes
No
If yes, when
Referred By:
GENERAL EDUCATION
High School:
Graduated?
Yes
No
ADVANCED EDUCATION
College:
Area of Study:
Graduated?
Yes
No
Trade School:
Area of Study:
Graduated?
Yes
No
Other Training:
GENERAL
Subjects of Special Study:
Special Training / Skills:
Activities:
MILITARY
US Military or Naval Services?
Yes
No
Present membership in National Guard or Reserves?
Yes
No
FORMER EMPLOYMENT
List below the last 4 employers starting with the most recent:
Business Name #1
City / State
Start Date:
End Date:
Starting Wage:
Ending Wage:
Position(s):
Reason for Leaving:
Business Name #2
City / State
Start Date:
End Date:
Starting Wage:
Ending Wage:
Position(s):
Reason for Leaving:
Business Name #3
City / State
Start Date:
End Date:
Starting Wage:
Ending Wage:
Position(s):
Reason for Leaving:
Business Name #4
City / State
Start Date:
End Date:
Starting Wage:
Ending Wage:
Position(s):
Reason for Leaving:
Add
Remove
REFERENCES
Give the names of 3 persons not related to you, whom you have known for at least 1 year.
Name #1:
Phone:
How are you acquainted?
Years Acquainted
Name #2:
Phone:
How are you acquainted?
Years Acquainted
Name #3:
Phone:
How are you acquainted?
Years Acquainted
Add
Remove
AVAILABILITY
Monday From:
Monday To:
Tuesday From:
Tuesday To:
Wednesday From:
Wednesday To:
Thursday From:
Thursday To:
Friday From:
Friday To:
Saturday From:
Saturday To:
Sunday From:
Sunday To:
Would this be a secondary job?
*
Yes
No
If Yes, how many hours do you work at your other job?
How many shifts per week do you want here?
Add
Remove
AUTHORIZATION
“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter in to any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. I understand that my employment is at will and can be dismissed within the first 30 working days for any reason and without warning.”
Authorization Agreement
*
I Agree
Submit
X
