Careers – Napa Valley Burger Company

EMPLOYMENT APPLICATION

This form must be completed in full and signed even if a resume is attached. Napa Valley Burger Company is an equal opportunity employer.

First Name

Last Name

Middle Initial

Home/Mailing Address

City

State

Zip Code

Position Desired

Date Available

May we contact your present employer?

If hired, can you furnish proof that you are 18years of age?
Note: If not, a work permit may be required.

Will you be able to perform the functionsdemanded by the job for which you are applying?

Have You Ever Worked ForAny Of Our Restaurants?

Are you 21 years of age or older?
(Answer only if applying for bartender position)

Can you provide original documents that establishyour eligibility to work inthe united states?

Have you ever been convicted of a felony?
A criminal record does not automatically disqualify you from employment consideration

Education

High school, college or technical training

City & state

Years

Degree or certificate

High school, college or technical training

City & state

Years

Degree or certificate

High school, college or technical training

City & state

Years

Degree or certificate

WORK EXPERIENCE

list below previous employers, beginning with the most recent

Employer

Job Title

From

Address

City

State

Zip Code

Phone

Name Of Supervisor

Reason For Leaving

Last Salary

Employer

Job Title

From

Address

City

State

Zip Code

Phone

Name Of Supervisor

Reason For Leaving

Last Salary

Employer

Job Title

From

Address

City

State

Zip Code

Phone

Name Of Supervisor

Reason For Leaving

Last Salary

ACKNOWLEDGEMENTS

1. I certify that all statements made on this application and on my resume or other supplementary materials are true and correct andany misrepresentation or omission of fact on this application may be cause for refusal of hire or for discharge at any time during theperiod of my subsequent employment should I be fired.

2. I authorize the restaurant to verify all verbal and written statements made by me that may include interviews of former employersand other references.

3. I authorize any and all former employers or educational institutions to release all information relevant to my employment oreducation

4. I agree that if I am hired, I will be free to resign my employment at any time with or without cause. NVBC may also terminate myemployment at any time with or without cause.

Thank you! Your submission has been received!

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