Application for Hourly Employment

Date of Application

Personal Information

First name*

Middle initial

Last name*

Social security number*

Phone*

Email address*

Address*

City & state

Zip*

General Information

Date of Availability

Are you a U.S. citizen? YesNo

If not a citizen, are you legally eligible to work in the United States?
YesNo

Are you at least 18 years of age?

Have you ever been convicted of a felony or misdemeanor within the last 7 years? YesNo

If yes, please explain?

Days of Availability

Saturday AMPMNone

Sunday AMPMNone

Monday AMPMNone

Tuesday AMPMNone

Wednesday AMPMNone

Thursday AMPMNone

Friday AMPMNone

High School Education

Select the highest grade completed
9101112GED

School name

City & state

School activities or athletics in which you participate

College Education

Select the highest grade completed
none1234

School name

City & state

Major

School diploma, degree, or certificate earned

Have you ever been employed by any Ponderosa or Bonanza Steakhouse? YesNo

If yes, please list location and dates employed?

Employment History

please list your record of employment beginning with your present or most recent job. Fill in completely.

Employer #1

Company name

City & state

Phone

Job title, duties and responsibilities

Reason for leaving

Dates of employment

Wage or salary

Other compensation (OT, bonuses, allowances)

Employer #2

Company name

City & state

Phone

Job title, duties and responsibilities

Reason for leaving

Dates of employment

Wage or salary

Other compensation (OT, bonuses, allowances)

If employed, may we contact your present employer?
YesNo

It is unlawful to require or administer a lie detector test as a condition for employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

If hired, you will be required to show proof that you are not under 18 years of age. If you are 18 years of age, we will require, prior to starting work, and Age Certificate or Work Permit issued through the local school district.

Agreement

In signing this application for employment, I understand that any misrepresentation or omission of a material fact may be cause for cancellation of this application or immediate dismissal. I agree that Metromedia Steakhouses Company, L.P. or any of it's subsidiaries shall not be liable in any respect if my employment is terminated because of false statements, answers or any omissions made by me on this application.

I understand that I may be asked to submit to a background investigation and if so required, I must satisfactorily pass such tests. I agree to sign an authorization to release such information necessary for such investigation to be conducted.

In signing this Agreement, I understand that Metromedia Steakhouses Company, L.P. may procure a credit check on me. I also understand that I have the right to request information regarding the scope and nature of the report.

I understand that if I obtain employment with Metromedia Steakhouses Company, L.P. my employment will not be for a fixed period of time and that I can be terminated at any time by the company or me, without liability to me for my wages, salary or benefits except what I have earned as of the date of termination.

I understand that I am not being hired to work in a specific job category or on a fixed schedule and that my scheduled hours may vary from week to week.

By submitting this application, you agree to the Terms above. Please read carefully.