Application Date (Required)

Full Name (Required)

Address (Required)

Phone Number (Required)

If offered employment, can you provide verification of your legal right to work in the United States? (Required)

Yes

Are you at least 18 years old? (Required)

Yes

Do you have any relatives employed by The Original Pancake House? (Required)

Yes

Have you ever been previously employed by The Original Pancake House? (Required)

Yes

If hired, would you have reliable transportation to and from work? (Required)

Yes

Have you ever been convicted of a criminal offense (felony or misdemeanor)? (Required)

Yes

Position you are applying for: (Required)

Available start date (Required)

Desired pay (Required)

Employment desired (Required)

Full Time

Part Time

Seasonal/Temporary

How were you referred to us? (Required)

Can you work weekends? (Required)

Yes

Can you work holidays? (Required)

Yes

Can you work overtime, if needed? (Required)

Yes

Hours Available Per Week:

Education: Please select the highest level of education you have completed

Please state the name and location of school:

Did you graduate?

Yes

What was your certificate/major/degree?

References: Please provide the names, titles, companies, and phone numbers for at least 3 references (2 professional):

Employment History

Employer 1: name and address (Required)

Employer 1: Job title (Required)

Employer 1: Dates employed (Required)

Employer 1: Work phone number (Required)

Employer 1: Starting and ending pay rates (Required)

Employer 1: Name and title of supervisor (Required)

Employer 1: Job description and major responsibilities (Required)

Employer 1: Reason for leaving or wanting to leave (Required)

Employer 2: name and address

Employer 2: Job title

Employer 2: Dates employed

Employer 2: Work phone number

Employer 2: Starting and ending pay rates

Employer 2: Name and title of supervisor

Employer 2: Job description and major responsibilities

Employer 2: Reason for leaving or wanting to leave

Employer 3: name and address

Employer 3: Job title

Employer 3: Dates employed

Employer 3: Work phone number

Employer 3: Starting and ending pay rates

Employer 3: Name and title of supervisor

Employer 3: Job description and major responsibilities

Employer 3: Reason for leaving or wanting to leave

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my termination. Please select "Yes" next to each statement to indicate your agreement.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. (Required)

Yes

I hereby authorize Food Dude, LLC dba The Original Pancake House to thoroughly investigate my references, work record, education and other matters related to my suitability for employment unless otherwise specified above. I further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. (Required)

Yes

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the Company's designated representative. (Required)

Yes

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. (Required)

Yes

Please type your full name below to certify that your answers are true and complete to the best of your knowledge. (Required)

Please select today's date (Required)

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