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Employment Application

Penny Black is an equal opportunity employer. We encourage all qualified individuals to apply for employment. If you require accommodations to complete the application, testing or interview process, please contact [email protected].

Use this application to apply for a position at Penny Black (Rochester).

We are currently hiring for servers, bartenders, barbacks, cooks, managers, hosts and doorstaff at Penny Black.

Date you are available to begin work:
Legal Full Name: *
Current Address: *
City: *
State: *
Zip: *
Phone: *
How we you refered to our company?:
E-Mail:
	I am at least 16 years old
	I am at least 18 years old
	I am legally authorized to work in the United States
Position applying for: *
Maximum number of hours you can work each week: *
Number of hours you would prefer to work each week: *
	I have completely open availability
Earliest Time Available to work Sundays:
Latest Time Available to Work Sundays:
Earliest Time Available to work Mondays:
Latest Time Available to work Mondays:
Earliest Time Available to work Tuesdays:
Latest Time Available to work Tuesdays:
Earliest Time Available to work Wednesdays:
Latest Time Available to work Wednesdays:
Earliest Time Available to work Thursdays:
Latest Time Available to work Thursdays:
Earliest Time Available to work Fridays:
Latest Time Available to work Fridays:
Earliest Time Available to work Saturdays:
Latest Time Available to work Saturdays:
High School Attended:
High School	Graduated/GED Still In SchoolNot In School
College/University/Vocational School Attended:
Degree/Job-Related Courses:
	Graduated/GED Still In School Not In School
Graduate Degree:
Degree/Job-Related Courses:
	Graduated Still In School Not In School
Current or Most Recent Employer:
Beginning Date of Employment:
End Date of Employment:
	Currently Employed
	May we contact this employer?
Phone:
City, State, Zip:
Job Title:
Job Duties:
Hourly Rate/Annual Salary:
Supervisors Name:
Reason for leaving:
Next Most Recent Employer:
Beginning Date of Employment:
End Date of Employment:
	May we contact this employer?
Phone:
City, State, Zip:
Job Title:
Job Duties:
Hourly Rate/Annual Salary:
Supervisors Name:
Reason for leaving:
Please list three people (references) that know you well and who we may contact. Do not list relatives or spouses. 1 Name:
1 Phone
1 Relationship:
2 Name:
2 Phone:
2 Relationship:
3 Name:
3 Phone:
3 Relationship:
To better serve our guests, what languages other than English can you speak and/or write?:
Please list any job related training or special skills that you may possess. Include TIPS, TAM, Servesafe Certifications:
	I have never been convicted of a crime other than a minor traffic violation
If answered no, please explain:
	By checking this box you are placing your digital signature, agreeing to the terms below.

We're glad that you're interested in joining our team. Our company complies with federal, state and local laws regarding equal employment opportunity. Qualified applicants are considered for all positions without regard to race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, citizenship status, military status, or any other basis protected by federal, state and/or local fair employment laws. Teamwork requires dedication, trust, and above all honesty. It is a commitment that we ask of all of our team members and potential team members. Please answer every question on the application completely and accurately without omitting any information. If you don’t answer every question completely and accurately or if you make false statements or misrepresentations during the interview or during the application process, and you are hired, you could lose your job regardless of how long you have been employed. This application is just that, an application. It is not an offer, promise or contract of employment, either expressed or implied. All of our team members are “at will” team members, which means that team members can terminate the employment relationship at any time, for any or no reason. Our Company reserves the right to change and/or terminate the team member’s employment, compensation and benefits, with or without notice or cause at any time. Our company will not, and team members or applicants should not, interpret any verbal or written statements, policies, practices, or procedures as altering their “at will” status. You understand that our Company may investigate the information provided on your application. You also understand that our Company may use an outside vendor to compile and process electronically the information you provide on this application during the hiring process. You release our Company, previous employers, any vendor our Company may use, and other persons from all claims and liabilities in connection with any investigation into information provided on your application (including the making of inquiries and furnishing of information) or in connection with furnishing information for the purpose of electronic compilation or processing of this information. If employed by our Company, you agree to read, understand, and comply with our Company’s policies and procedures that may change from time to time.

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