Restaurants Hiring | Work at Georgie Porgie’s

Which location are you applying for? Which location are you applying for? Oak Creek Mt. Pleasant/Racine

Position Applying For: Position Applying For: Team Member Shift Leader General Manager

Name (first, middle, last)

Today's Date

Address:

Email Address

City:

State:

Zip Code:

Phone:

Date available to start:

How many hours a week do you want to work?

Wage expectation

Are you at least 18 years old? Are you at least 18 years old? Yes No

If no, date of birth

The U.S Secretary of Health and Human Services has determined that certain diseases, including hepatitis A, salmonella shigella, staphylococcus, streptococcus, giardia and camplobacter, may prevent you from handing or serving food in a sanitary and healthy fasion. An essential function of this job is serving and handling food in a sanitary and healthy fashion. Can you, with or without reasonable accomodations, perform thes essential function of this job? The U.S Secretary of Health and Human Services has determined that certain diseases, including hepatitis A, salmonella shigella, staphylococcus, streptococcus, giardia and camplobacter, may prevent you from handing or serving food in a sanitary and healthy fasion. An essential function of this job is serving and handling food in a sanitary and healthy fashion. Can you, with or without reasonable accomodations, perform thes essential function of this job? Yes No

Are you legally authorized to work in the U.S.A? Are you legally authorized to work in the U.S.A? Yes No

Employer 1 (name ,city, state)

Dates employed

Final pay rate

Job title & duties; supervisors name & phone

Reason for leaving

Employer 2 (name ,city, state)

Dates employed

Final pay rate

Job title & duties; supervisors name & phone

Reason for leaving

Employer 3 (name ,city, state)

Dates employed

Final pay rate

Job title & duties; supervisors name & phone

Reason for leaving

Name of most recent school attended

City & state

Enrolled now? Enrolled now? Yes No

Have you graduated? Have you graduated? Yes No

What is your availability? What is your availability? Anytime Monday AM Tuesday AM Monday PM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM Saturday AM Saturday PM

At Georgie Porgies we do not discriminate on the basis of race, sex, color, religion, national origin, sexual orientation, age, disability, marital status, veteran status or any other factors made unlawful under applicable federal, state, and local legislation. All personnel decisions are made without prejudice or discrimination in accordance with the principles of equal opportunity. We are willing to discuss reasonable accommodations for disability and religion needs as it relates either to the job or the application process

The information I am submitting is complete, true and correct to the best of my knowledge. I understand that any falsification, misrepresentation or omission could result in the denial of my application, withdrawal of any employment offer, or immediate discharge. Georgie Porgies is committed to compliance with immigration laws regarding verification of employment eligibility. Any offer of employment will be contingent upon your ability to provide documentation showing employment eligibility. If employed, I agree to conform to the rules and regulations of my employer and understand that I will be an employee-at-will and my employment may be terminated at any time by me or my employer, with or without notice for any reason.

Georgie Porgie’s is Hiring Smiling Faces

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