Name

First Name

Last Name

Address

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Email Address

Subject

Message

Location Preference

Opportunity Desired

Availability

Morning Shift

Night Shift

Flexible

Weekends

Position Desired

Buser

Cashier

Cook

Dishwasher

Grill Cook

Kitchen Assistant

Meat Carver

Date Available to Start

YYYY

Salary Desired

Have you ever applied at Pampas Grill or Phil's Deli?

If yes, when?

Do you have any commitments that could interfere with the regular performance of your duties at Pampas Grill? If YES, please explain:

Describe any specialized training , apprenticeship and/or skills which relate to your ability to perform the job you have applied for:

Name & Address of the Company

Company Phone Number

(###)

###

####

Position Held

Start Date of Employment

YYYY

End Date of Employment

YYYY

Supervisor's Name

Duties Performed

Reasons for Leaving

May we contact this employer?

Name & Address of the Company

Company Phone Number

(###)

###

####

Position Held

Start Date of Employment

YYYY

End Date of Employment

YYYY

Supervisor's Name

Duties Peformed

Reasons for Leaving

May We Contact This Employer

Are you currently enrolled in school?

Do you have any trips planned in the next six months?

Do you speak any foreign languages?

Do you have any friends or relatives employed by Pampas Grill, Phil's Deli & Grill or any restaurant/store in the Farmers Market or Culver Center?

Is there any other job related information you would like to add?

Professional:

Personal:

Have you been convicted of a felony in the past ten (10) years?

I hereby affirm that the information provided herein and attached hereto is true, accurate, and complete to the best of my knowledge. I authorize Pampas Grill to make such investigations and inquiries of the information provided and in regard to other matters related as may be necessary. I release Home Cooking, Inc. and/or Pampas Grill, Inc., its officers, and employees from all liability in connection with these actions. Additionally, I release Home Cooking, Inc. and/or Pampas Grill, Inc., its officers, employees, representatives, employers, schools, institutions and/or businesses responding to investigations and inquiries from all liability in connection with my application for employment.

I understand that false, misleading, incomplete, or inaccurate information given in this application during interviews or otherwise provided may result in refusal to hire, or discharge in the event of employment.

I acknowledge that by signing this application I am authorizing Home Cooking, Inc. and/or Pampas Grill, Inc. to contact individuals I have identified as references, former employers (if applicable), and educational institutions to confirm the information provided. I authorize all my previous employers, schools, and other references to release the information requested. I agree that employment with Pampas Grill is contingent upon satisfactory results of this investigation. I understand and agree that nothing in this application is intended as, or shall constitute a contract of employment or guarantee of employment.

I understand and agree, that if hired my employment is at will. I may terminate my employment at any time, and I may be dismissed at any time without prior notice.

Finally, I understand that if hired, my employment is for no definite period of time. I understand that if hired, I will be on a 5 day trial period. During the 5 day trial period, your work will be evaluated, including your interaction with coworkers and customers (if applicable) to determine if you are suitable for the position after the trial period has ended.

If the trial period is completed successfully, you will resume employment and continue to fulfill the 90 day probation period. If it has not been executed successfully, necessary steps will be taken to inform you of the results and begin the termination process.

SIGNATURE OF APPLICANT:

Work at Pampas

Employee Application

LOCATIONS

HOURS