Employment — Our Favorite Bar

List names of employers, in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give full name and supply business references.

Name of Employer 1 *

Dates Worked at Employer 1

When did you work (month/year to month/year)?

Employer 1 Name and Title of Last Supervisor?

Employer 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Pay at Employer 1?

Reason for Leaving Last Job?

Title at Employer 1 Job?

Duties at Employer 1?

Name of Employer 2

Dates you worked at Employer 2

When did you work at Employer 2? (month/year to month/year)

Employer 2 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Pay at Employer 2?

Employer 2 Phone

(###)

###

####

Employer 2 Reason for Leaving?

Title at Employer 2?

Duties at Employer 2

REFERENCES

Give three references, not relatives or former employers.

Reference 1 Name

Reference 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference 1 Phone

(###)

###

####

Reference 1 Occupation

Reference 2 Name

Reference 2 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference 2 Phone

(###)

###

####

Reference 2 Occupation

Special Skills: Please let us know why you would like to join our team. Include any special skills, experience, personality traits, or anything else that you think would be important to helping you succeed with us.

Employment Application Addendum

Equal Opportunity Employer Questionnaire For Federal/State Statistical Reporting Requirements All applicants for employment are requested to complete this form. Your voluntary submission of this information will assist us to comply with Federal Equal Opportunity statistical reporting and research requirements. Data collected will be used for statistical reporting purposes and to measure the effectiveness of recruitment efforts and selection process. Your refusal to complete this form will not affect the status of your application. This section will be detached from the application and will not become a part of your file. It will be kept confidential and retained separately for statistical purposes ONLY. Our Favorite Bar is an equal opportunity employer. In accordance with applicable laws and regulations, Our Favorite Bar does not discriminate on the basis of disability or other prohibited criteria. Any applicant who feels discriminated against in his or her opportunity for employment because of race, color, creed, national origin, age, political affiliation, disability or any other non-merit factor has the right to file a complaint.

Age

Under 20

20-39

40-65

66 or over

Are you a veteran of the United States Armed Forces

yes

If a veteran, which Branch of Service?

Type of Discharge?

Have you been unemployed in the past 60 days?

yes

AFFIDAVIT

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form or during any interviews may be grounds for my immediate discharge. l hereby authorize the company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right; to bring any course of action against these individuals for defamation, invasion of privacy or any other reason because of their statements. I agree that if I am employed, I will abide by all the rules and regulations of the company. I understand that the taking of drug and alcohol tests, when given pursuant to company policy, are condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination. I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of the President of the Company. I also understand that my employment is ‘at will’ and may be terminated by myself or by the company at any time for any reason or no reason at all, with or without prior notice.

Digital Signature

Please type your first and last name here to digitally sign this Employment Application

Today's Date

YYYY

Thank you!

Locations

Nutty Squirrel, River Falls, WI (715) 425-9064
Cheap Andy’s, Hammond, WI (715) 796-4477
Heartbreakers, Chippewa Falls, WI (715) 514-4536
Tipsy Tavern, Rice Lake, WI (715) 234-1818
Cheap Andy’s, La Crosse, WI (608) 796-2891
Next Door Pizza Pub, Chippewa Falls, WI (715) 557-4992

Our Favorite Bar

Contact

Ana Mae Larson / General Manager @ Nutty Squirrel Sports Saloon in River Falls, WI

Robert Comstock / General Manager @ Cheap Andy’s Saloon in Hammond, WI

Shannon Gilmore / General Manager @ Heartbreakers in Lake Hallie, WI

Honey LaSieur / General Manager @ Tipsy Tavern in Rice Lake, WI

Jared Larson / General Manager @ Cheap Andy’s LAX in La Crosse, WI

Jesse Poulter / General Manager @ Next Door Pizza Pub