The Grill Next Door - Application for Employment

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, disability, veteran status or any other
legally protected status.
Position(s) Applied For:

How did you hear about us?:
Applicant Information
Name (First, Last, Middle Int.):

Street Address:

City/State/Zip:
phone:
email:
Date of Birth:
If hired, do you have reliable means of transportation to get to work?:
 Yes
No
Yes
No
Are you 18 years old?:
Today's Date:
Are you legally eligible for employment in the U.S.? (Proof of U.S.
citizenship or immigration status is required if hired.):
No
Yes
Have you been convicted of a crime? (Massachusetts applicants should not
include misdemeanor convictions)
Yes
No
If yes, state the nature of the offense and disposition of the case. Include
dates and places.  (NOTE: The existence of a criminal record does not
constitute an automatic bar to employment.)
Are you a Veteran?
 Yes
 If yes, please list dates of service:
No
List any special skills or training:
Employment Information
Temporary
Part Time
Are you seeking full time, part time or temporary employment?
 Full Time
What hours and shift(s) would you prefer to work?
List times you are not available to work?
Holidays
Are you willing to work overtime?
 Weekends?
Are you currently employed?
 If hired, when could you start?
List any friends or relatives employed by The Grill Next Door or the One Stop Market:
Have you ever been discharged or asked to resign
from any position?
If yes, please describe:
Education (select highest level achieved)
Elementary
 Name of High School:
GED
College
Name of College:
Work History (please begin with most recent)
Company Name:
 Phone w/ Area Code:
Address:
City/State/Zip:
Supervisor Name:
Job Title:
Date of Employment:
 From - To:
Brief description of your responsibilities:
Phone w/ Area Code:
Company Name:
Address:
City/State/Zip:
Supervisor Name:
Job Title:
Date of Employment:   From - To:
Brief description of your responsibilities:
Please list any other relevant work experience:
Authorizations & At-Will Employment Agreement
(please read carefully, then click the agree button and date below)
Required: I agree to submit my information to this website. I agree that filling out this fields acts
as a signature agreeing to the Authorizations & At-Will Employment Agreement listed below.
I certify that I have personally completed this application. I declare that the information provided in this employment
application is true and complete and I understand that any false information or significant omissions may disqualify me
from further consideration for employment and may be justification for my dismissal from employment if discovered at a
later date. I agree to immediately notify this company if I should be convicted of a crime while my job application is
pending or during my employment, if hired.

I authorize this company to make an investigation of all information contained in this employment application and I
release from liability all companies and corporations supplying such information. I understand any false answers,
statements, or implications made by me on this application or other required documents shall be considered sufficient
cause for denial of employment or discharge.

I specifically authorize and direct my current and former employers to supply employment-related information to this
company and do hereby release my current and former employers from liability for providing information to this
company.  

Upon termination of my employment for whatever reason, I release this company from all liability for supplying any
information concerning my employment to any potential employer.

I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other
investigative report deemed necessary through various third party sources. As required by law, upon request within a
reasonable period of time, I will be notified as to the nature and scope of such investigations.

I hereby agree to submit to any drug test required of me, whether prior to my employment or if employed by this
company at any time thereafter. If requested, I will take a post-job offer physical examination and my employment, in the
event I receive medical treatment for any condition, including a physical, psychological, emotional, or psychiatric
condition that is job-related, I hereby authorize the limited release and exchange of such medical information relating to
my condition between the treatment provider and a company-designated physician.

AT-WILL EMPLOYMENT AGREEMENT

I understand and agree that nothing contained in this application, or conveyed during any interview is intended to create
an employment contract between the company and me. In addition, I understand and agree that if you employ me, in
consideration of my employment, my employment and compensation will be at-will, for no definite period of time, and
may be terminated at any time, for any reason, or for no reason at all. I understand that only the company’s President is
authorized to change the employment-at-will status and such a change can only be done in writing.  I have read,
understand, and agree to the above.
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