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Fredericksburg
10040 Patriot Highway
Fredericksburg VA
540-898-8338
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Employment
Employment
Please fill in all the required fields
PERSONAL INFORMATION
Date of Application
*
First Name
*
Last Name
*
Email Address
*
Email Address Confirmed
*
Home Address
*
Apt./Unit #
City
*
State
*
Zip Code
*
Home Phone Number
*
Cell Phone Number
Can you submit proof of legal employment authorization and identity?
*
Yes
No
If you are under 18, can you furnish a work permit?
*
Yes
No
Have you ever been previously employed by our organization?
*
Yes
No
If yes, where?
*
If yes, when?
*
Have you ever been convicted of a felony in the last 7 years?
*
Yes
No
If yes, explain.
*
Select Location Desired
*
Choose a location
Huntsville Jordan Lane
Huntsville Memorial Pkwy
Madison
Jonesboro AR Alexander Drive
Jonesboro AR Parkwood Road
Owasso
Philadelphia Roxboro
Nolensville Hillside Center
Greenville
Laredo
Fredericksburg
Select Position Desired
*
--Select a Position--
Server
Bartender
Hostess
Cook
Manager
Accounting
Marketing
Operations
Finance
HR
Delivery Driver
Counter Help
Other
Salary Desired
Are you currently employed?
*
Yes
No
If yes, may we contact your previous employer?
*
Yes
No
Select Availability
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Date Available
*
Referred By
Phone Number
Continue
PREVIOUS EMPLOYMENT
PREVIOUS JOB #1
Company
Phone
Address
Supervisor
Position
Salary
Employed From
Employed To
Reason for leaving
PREVIOUS JOB #2
[+]
Company
Phone
Address
Supervisor
Position
Salary
Employed From
Employed To
Reason for leaving
PREVIOUS JOB #3
[+]
Company
Phone
Address
Supervisor
Position
Salary
Employed From
Employed To
Reason for leaving
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EDUCATION
High School
*
Address
From
*
To
*
Did you graduate?
*
Yes
No
Degree Earned
College
Address
From
To
Did you graduate?
Yes
No
Degree Earned
Technical/Trade
Address
From
To
Did you graduate?
Yes
No
Degree Earned
Other
Address
From
To
Did you graduate?
Yes
No
Degree Earned
Skills and Qualifications
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REFERENCES
REFERENCE #1
Full Name
*
Relationship
*
Years Known
*
Address
*
Phone
*
REFERENCE #2
Full Name
*
Relationship
*
Years Known
*
Address
*
Phone
*
REFERENCE #3
Full Name
*
Relationship
*
Years Known
*
Address
*
Phone
*
Upload
Signature Full Name
*
Signature Date
*
Signature Certify
*
Yes, I would like to receive Email Alerts
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