Thank you for your interest in joining our team at Proximity Hotel, Print Works Bistro, O.Henry Hotel, Green Valley Grill & Lucky 32 Southern Kitchen
 
         
 

Application for Employment
(An Equal Opportunity Employer)

 DATE:
 
Please send my application to:
Proximity Hotel Print Works Bistro O.Henry Hotel
Green Valley Grill Lucky 32 Greensboro Lucky 32 Cary
 
PERSONAL INFORMATION:
 
Name: *
 
 
 
First
 
Middle
 
Last
 
Present Address: *
 
, 
 
 
Address
 
City, State
 
Zip
 
Permanent Address:
 
, 
 
 
Address
 
City, State
 
Zip
 
Phone Number: *
  Email Address:  
 
Are you 18 years or older?*
YES
     NO
Are you legally authorized to work within the United States?*
YES
     NO
         
 
POSITION INFORMATION :
 
Position Desired :
 
Salary
Desired:
  Date you
can start:		  
 
Are you
employed now?:
  If so, may we inquire of your present employer?:  
 

Have you ever applied to this company before?

YES NO

If Yes, where? (check all that apply)

Lucky 32 Greensboro
Lucky 32 Cary
Green Valley Grill
Print Works Bistro
O.Henry Hotel
QWM Office

When?

 
Referred by :
     
         
 
EMPLOYMENT HISTORY:
 
Dates of
Employment 		Name and Address
of Employer

Salary

Position Reason
for Leaving
From:
To:

From:
To:

From:
To:

  Which of these jobs did you like best?
What did you like most about that job?
         
 
EDUCATION:
 
EDUCATION Name and
Location of School

# of years
attended

Did you graduate? Subjects
of Study
High School
College
Other
  Subjects of special study or research work :
Special skills:
Current Activities:
(exclude organizations, the name of which indicates the race, creed, sex, age, marital status or nation of origin of its members)
         
 
REFERENCES:
Give the names of three persons, not related to you, whom you have known for at least one year and whom we may contact:
 
 Name Known Address  Phone Number  Business  Years
         
 

IN CASE OF EMERGENCY NOTIFY:

 
 Name  Address  Phone Number
         
 

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing the same to you.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice and without cause."

Date:
    Signature: