Briarpatch Restaurant Application of Employment
Quality, Service, Cleanliness- Our Recipe for Success!

Briarpatch Restaurant agrees and complies with all statutes to protect people from discrimination on the basis of race, color, religion, sex, national origin, age or handicap. Briarpatch Restaurant affirmatively supports equality of opportunity in all aspects of employment.
Name (First, Middle, Last) *
Phone number *
Email address
Present Address (Street, City, State, Zip) *
Job you are applying for *
Are you interested in full time employment or part time employment? *
When will you be available to start working? *
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Are you...? *
Are you a US citizen? *
Have you ever been convicted of a felony in the past 7 years? *
Do you have any physical or mental limitations preventing you from performing restaurant specific work? *
If yes, please explain limitations:
Are you restricted as to what days per week or hours per day you can work? *
If yes, please give details:
High School: Please provide the name, date graduated (if applicable) and grade average. *
Are you presently in a work study class?
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Have you attended a culinary or food service school? If yes, please give details:
Have you attended college/university? If yes, please give details:
Have you been a member of the U.S. military? If yes, please describe including, branch, rank, and if your duties were job related:
Special Qualifications: Please list any skills, talents, knowledge, or other related experience: *
Previous Employment: Company Name *
Company address (city, state, zip) *
Job held: *
Rate of pay: *
Dates of employment (date started and date left): *
Reason for leaving: *
Previous employment (2): Company name
Company address (city, state, zip)
Job held:
Rate of pay:
Dates of employment (date started and date left):
Reason for leaving:
Please list the information for any additional employment: Company name, address, job held, rate of pay, dates employed and reason for leaving.
Please list the information for any additional employment: Company name, address, job held, rate of pay, dates employed and reason for leaving.
Please list the information for any additional employment: Company name, address, job held, rate of pay, dates employed and reason for leaving.
IMPORTANT- PLEASE READ CAREFULLY
This company adheres to a policy of non-discrimination with respect to age, sex, race, national origin, or handicap. The Age Discrimination Act of 1967 as amended prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.
A routine inquiry may be made during the processing of this application that will provide information concerning your employment records and/or education. Information as to the nature and scope of this inquiry will be provided upon written request.
Applicant accepted for employment are hereby notified that employment and compensation can be terminated, with or without cause or notice at any time at the option of either the company or employee. No representative of the company other than the chief executive officer of Briarpatch Restaurant has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing.

In digitally signing this application, applicant agrees that all information here has been read and understood and that the information provided by the undersigning is true and complete and that any misrepresentation, falsification, or willful omission may be significant reason for refusal of employment or dismissal after employment.
Application's digital signature: *
Person to notify in case of emergency: Name and phone number *
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