White Star Ale House - Cedar Rapids, Iowa

This company is an equal opportunity employer and does not unlawfully discriminate on the basis of race, sex, age,color, religion, national origin, marital status, veteran status, disability status, or any other basis prohibited by Federal, State or local law. Please let us know if you need accommodations in order to participate in the application process.

If your application with the White Star Ale House is accepted, your employment will be on an “at will” basis. This means that you may terminate your employment with the Company at any time for any reason, and that Company may, likewise, terminate your employment at any time, and for any reason, except reasons which are specifically prohibited by law.

Name

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Phone

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Today's Date

Address

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Date Available for Work

Position Applied For

Salary Desired

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Emergency Phone

Are you over the age of 18?

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No

Will VISA or immigration status prevent lawful employment?

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Education / Highest grade level completed

Who referred you to this company?

Have you ever been convicted of or pled no contest to any felony criminal offense?

Yes
No

If yes, please explain. (A conviction will not necessarily disqualify an applicant from employment.)

Employment Record

1.) Employer, Dates, Salary, Position, Supervisor, Reason for Leaving?, Eligible for rehire?

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2.) Employer, Dates, Salary, Position, Supervisor, Reason for Leaving?, Eligible for rehire?

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3.) Employer, Dates, Salary, Position, Supervisor, Reason for Leaving?, Eligible for rehire?

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4.) Employer, Dates, Salary, Position, Supervisor, Reason for Leaving?, Eligible for rehire?

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Can you perform, with or without accomodation, the essential duties of the job for which you are applying?

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U.S. Military Service?

Yes
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Experience - check all that apply

Experience - other

Files you want to share (e.g. Resume)

I certify that the information given by me to the White Star Ale House is true to the best of my knowledge. I understand that if I am employed, discovery that I gave false information during the application process may result in immediate dismissal. I further certify that I am not engaged in any outside activity or business that could be considered in conflict with (Employer’s) interest or those of its customers, nor will I become engaged in such activity or business if employed. I authorize the White Star Ale House to solicit information regarding my education and previous employment, and to contact any and all references I have given on my application. I herby release all parties and persons connected with any such request for information from all claims, liabilities, and damages for any reason arising out of the furnishing of such information. If employed, I release the company from any liability for future references it may provide regarding my work history with the White Star Ale House or myself. I understand that no representative of the White Star Ale House, other than Management (Mr. White or Mr. Franks), has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoin

Application for Employment

Employment Record