Black Cow – Job Application – Black Cow Restaurant

Please Answer All Questions. Résumés Are Not A Substitute For A Completed Application.

We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed servicemember status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state, or local laws.

For Rhode Island Employers Only: This Company is subject to the Workers' Compensation laws of the State of Rhode Island.*

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.
Position Applied For
Name
First Last
Phone
Alternate/Cellular Telephone Number
Email
Address
Present Street Address Address Line 2 City State ZIP Code
Desired Salary/Hourly Rate
If under the age of 18, can you produce the necessary work certificate at the time of employment?
- Yes
- No
Type of employment desired?
- Full-time
- Part-time
Date on which you can start work if hired
Month
Day
Year

WORK EXPERIENCE - Employer field 1
Please list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for at least the most recent ten (10) year period. Attach additional sheets if needed. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Do not answer "see résumé."
Employer
Address
Street Address Address Line 2 City State ZIP Code
Phone
Type of Business
Start date employed
Month
Day
Year
End date employed
Month
Day
Year
Supervisor's Name
First Last
May we contact your previous employer?
- Yes
- No
If "No", please state reason below.
Reason for not contacting previous employer
Wages Start
Wages Final
Reason for leaving?
Do you have additional work history?
- Yes
- No
Please provide at least 2 employment histories if possible.

WORK EXPERIENCE - Employer Field 2
Employer
Address
Street Address Address Line 2 City State ZIP Code
Phone
Type of Business
Start date employed
Month
Day
Year
End date employed
Month
Day
Year
Supervisor's Name
First Last
May we contact your previous employer?
- Yes
- No
If "No", please state reason below.
Reason for not contacting previous employer
Wages Start
Wages Final
Reason for leaving?
Add an additional work history?
- Yes
- No

WORK EXPERIENCE - Employer Field 3
Employer
Address
Street Address Address Line 2 City State ZIP Code
Phone
Type of Business
Start date employed
Month
Day
Year
End date employed
Month
Day
Year
Supervisor's Name
First Last
May we contact your previous employer?
- Yes
- No
If "No", please state reason below.
Reason for not contacting previous employer
Wages Start
Wages Final
Reason for leaving?

REFERENCES
Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school or volunteer-related references.
Reference 1
Name
First Last
Position
Company
Work Relationship

i.e. supervisor, co-worker, client
Phone
Reference 2
Name
First Last
Position
Company
Work Relationship

i.e. supervisor, co-worker, client
Phone
Reference 3
Name
First Last
Position
Company
Work Relationship

i.e. supervisor, co-worker, client
Phone

AUTHORIZATION
THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OF THE COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT—EXPRESS OR IMPLIED—WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS IN A WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF THE COMPANY.IF HIRED, I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL. I authorize the Company or its agents to confirm all statements contained in this application and/or résumé as it relates to the position I am seeking to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation which may be permitted by federal, state and/or local law. If applicable and allowed by law, I will receive separate written notification regarding the Company's intent to obtain "consumer reports." I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. I hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the company to provide truthful information concerning my employment to future employers and hold the company harmless for providing such information.

If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States.

THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY.

I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE.

DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THE APPLICATION.
Consent to the above terms of the application
- I agree
- I do not agree
Date
Month
Day
Year

Black Cow – Job Application

Step 1 of 6 - Personal Information

WORK EXPERIENCE - Employer field 1

WORK EXPERIENCE - Employer Field 2

WORK EXPERIENCE - Employer Field 3

REFERENCES

Reference 1

Reference 2

Reference 3

AUTHORIZATION

LOCATION

Hours

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