Employment Application

ButtercuP Diner & Bar is an Equal Opportunity Employer. Fields marked with * are required.

Applicant Information

The Company is an equal opportunity employer dedicated to a policy of non-discrimination in employmenton any basis including race, color, age, sex, religion, national origin, ancestry, disability, medical condition,marital status, pregnancy (including breastfeeding and related medical conditions), sexual orientation, gender(including gender identity and gender expression), genetic information, military or veteran status, or anyother characteristic protected by applicable state, federal and/or local laws. The Company provides equalpay in conformity with the law, regardless of gender, race or ethnicity.

Availability

Check every shift you are available to work. AM = morning shift, PM = evening shift.

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Education and Training
Employment History

List all present and past employment, starting with your most recent employer (the last five years is sufficient). You must complete this section even if you attach a resume. Employer 1 is required.

Employer 1*

Employer 2

Employer 3

Employer 4

References

References are optional. If you have them, list up to three persons not related to you who have knowledge of your work performance within the last three years.

Reference 1

Reference 2

Reference 3

Certification and Authorization

Please read carefully, initial each paragraph, and sign below.

I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of my statements checked by the company unless I have indicated to the contrary. I authorize the references listed above, as well as all other individuals whom the company contacts, to provide the company any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all schools, employers and persons from any and all liability for any damages that may result from furnishing such information to the Company as well as from any use or disclosure of such information by the company or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or, if I am hired, my immediate termination from employment.In consideration of my employment, I agree to conform to the rules, policies, procedures and standards of the Company. I further agree that my employment and compensation can be terminated “at-will,” with or without cause, and with or without notice, at any time, either at my option or at the option of the Company. I understand that no employee or representative of the Company, other than a member of ownership has the authority to enter into any agreement for employment for any specified period of time, or to make any express or implied agreement contrary to the foregoing. Further, a member of ownership may not alter the "at-will" nature of the employment relationship or enter into any employment agreement for a specified time unless he and I both sign a written agreement that clearly and expressly specifies the intent to do so. I agree that this shall constitute a final and fully binding integrated agreement with respect to the “at-will” nature of my employment relationship and that there are no oral or collateral agreements regarding this issue.I also understand that all offers of employment are conditioned on the Company’s receipt of satisfactory responses to reference requests and the provision of satisfactory proof of an applicant’s identity and legal authority to work in the United States.

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AN EQUAL OPPORTUNITY EMPLOYER