Beaverton, OR APPLICATION FOR EMPLOYMENT Meridian, ID AN ...
FUN, SAFE & REWARDING
APPLICATION FOR EMPLOYMENT
AN EQUAL OPPORTUNITY EMPLOYER
Beaverton, OR Meridian, ID Ontario, CA
Vancouver, WA
PERSONAL INFORMATION
PLEASE ASK IF YOU NEED ASSISTANCE COMPLETING THIS APPLICATION, INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
POSITION APPLYING FOR: _________________________________________________________________________________________________
LAST NAME
FIRST NAME
MIDDLE INITIAL
STREET ADDRESS
CITY
STATE
ZIP CODE
PRIMARY PHONE (
Mobile Home
) ________________________________
SECONDARY PHONE (
Mobile Home
) __________________________________
EMAIL ADDRESS
Were you known by any other name? Yes No
If yes, what name? ________________________________________________________
What is your desired wage rate? $_____________ Per hour Per year
Are you legally eligible to work in the United States? Yes No
Proof of right to work in the U.S. will be required upon hire.
Are you 18 years or older? Yes No
If no, employment is subject to minimum legal age requirements.
High School
College Trade, Business, or Graduate School
EDUCATION
Name and Location of School
Years Completed
Yes
No
1 Year
4 Years
GRADUATE
Degrees Received
Typing: ________WPM
Ten Key: Touch
Sight
Foreign Language Skills:
Computer and software used: _____________________________________________________ Other computer skills: ___________________________________________________________ Accounting: ___________________________________________________________________
Indicate any other related skills: _______________________________________________________________________________________________
REFERENCES
INCLUDE AT LEAST TWO PROFESSIONAL REFERENCES
REFERENCES FIRST AND LAST NAME COMPANY/TITLE COMPLETE ADDRESS AND TELEPHONE NUMBER YEARS RELATIONSHIP
KNOWN
TO YOU
Have you worked at a Big Al's entertainment center before? Yes No If yes, which location:_O__n__ta__r_io__,_C__A________________________ How did you hear about this position: Craigslist Indeed Referral:________________________ Other:___________________________
Page 1 of 3
EMPLOYMENT RECORD
LIST THE PREVIOUS FIVE YEARS OF EMPLOYMENT STARTING WITH YOUR MOST RECENT EMPLOYER, INCLUDING MILITARY SERVICE
Employer
May we contact this employer? Yes No Telephone (
)_____________________
Address Job Title Dates Employed: From Duties
City
State _______ Zip Code __________________
Supervisor ______________________________________________________
To
Reason for leaving
Employer Address Job Title Dates Employed: From Duties
May we contact this employer? Yes No Telephone (
)_____________________
City
State _______ Zip Code __________________
Supervisor ______________________________________________________
To
Reason for leaving
Employer Address Job Title Dates Employed: From Duties
May we contact this employer? Yes No Telephone (
)_____________________
City
State _______ Zip Code __________________
Supervisor ______________________________________________________
To
Reason for leaving
Employer Address Job Title Dates Employed: From Duties
May we contact this employer? Yes No Telephone (
)_____________________
City
State _______ Zip Code __________________
Supervisor ______________________________________________________
To
Reason for leaving
WORK AVAILABILITY
CHECK ALL BOXES THAT INDICATE WHEN YOU ARE AVAILABLE TO BE SCHEDULED
Monday AM
PM
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Date available for work?
Shift(s) Available: Days Evenings Nights
Would you prefer to work: Full time Part time Temporary
If you have pre-planned vacations, please list: _______________________________________________________ Additional Scheduling Requests: ________________________________________________________________
Page 2 of 3
BACKGROUND CHECK DISCLOSURE
Big Al's, Inc., referred to as "the Company," may order a "consumer report" (a background report) or "investigative consumer report" on you in connection with your employment application, and if you are hired, or if you already work for the Company, may order additional background reports on you for employment purposes, to the maximum extent permitted by applicable law.
The background check company, ADP Screening and Selection Services, will prepare the background report for the Company. ADP Screening and Selection Services is located at 301 Remington Street, Fort Collins, CO, 80524, and can be reached by phone at 800367-5933 or at their Internet Web site address .
The background report may contain information concerning your character, general reputation, personal characteristics, mode of living, criminal history, and credit standing. An "investigative consumer report" is a background report that includes information from personal interviews. Information may be obtained from private and public sources and for investigative consumer reports from personal interviews as noted above. You may request more information about the nature and scope of an investigative consumer report, if any, by contacting the Company.
The Fair Credit Reporting Act gives you specific rights in dealing with consumer reporting agencies. You will find these rights summarized in the document titled A Summary of Your Rights Under the Fair Credit Reporting Act.
APPLICANT'S STATEMENT PLEASE READ CAREFULLY BEFORE SIGNING
Big Al's is an equal opportunity employer. In addition to city, county and state laws, Big Al's does not discriminate in employment due to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.
I certify that the information contained in this application is true and complete to the best of my knowledge. I understand that false or misleading information written on my application may result in denial of my employment or immediate termination and that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Big Al's to hire me.
I authorize Big Al's to investigate all statements contained in this application and to request information about me from previous employers and above listed references. I expressly authorize my previous employers to provide information and opinions concerning my work and work habits. Further, I release all parties including Big Al's and persons connected with any requests for information from all claims, liabilities, and damages arising out of furnishing information that may be sought in an employment decision.
By signing below I acknowledge that I have read, received, understand and will comply with the Applicant's Statement.
Signature of Applicant
Date
Page 3 of 3
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