Application

All qualified applicants for employment receive consideration for employment without regard to race, color, religious affiliation, sex, national origin, age, sexual orientation, gender variance, marital status, veteran status, disability, or any other status protected by applicable law or regulation. This application is valid for 60 days.

The Black-eyed Pea Restaurants reserved the right to assign any employee to any geographically proximate work site. This decision is based solely upon the operational need of Black-eyed Pea Restaurants.

Miscellaneous

Please specify how you found out about our company (Select one)

If you selected Referred or Other, please list Referral or explain other here.

Education

High School

Name and Location:

Highest Grade / Level:

Diploma or Degree Earned

College, Graduate, Business, Vocational, or Other Training

Name and Location:

Highest Grade / Level:

Diploma or Degree Earned

Name and Location:

Highest Grade / Level:

Diploma or Degree Earned

Name and Location:

Highest Grade / Level:

Diploma or Degree Earned

Name and Location:

Highest Grade / Level:

Diploma or Degree Earned

Employment History

Please list all jobs, beginning with your present or last employer. Account for all periods, including unemployment, self-employment, and any military service.

1. Current or Most Recent Employment

Company Name:

Address:

Employment Dates:

Start

End

Salary:

Start

End

Hour Worked Per Week:

Job Title

Duties and Responsibilities

Reason for leaving or wishing to leave:

May we contact you previous employer? Yes No

Supervisor:

Name:

Title:

Phone Number:

2.

Company Name:

Address:

Employment Dates:

Start Date:

End Date:

Salary:

Start

End

Hours Worked Per Week:

Job Title

Duties and Responsibilities

Reason for leaving or wishing to leave:

May we contact your previous employer? Yes No

Supervisor:

Name:

Title:

Phone Number:

3.

Company Name:

Address:

Employment Dates:

Start Date:

End Date:

Salary:

Start

End

Hours Worked Per Week:

Job Title

Duties and Responsibilities

Reason for leaving or wishing to leave:

May we contact your previous employer? Yes No

Supervisor:

Name:

Title:

Phone Number:

4.

Company Name:

Address:

Employment Dates:

Start Date:

End Date:

Salary:

Start

End

Hours Worked Per Week:

Job Title

Duties and Responsibilities

Reason for leaving or wishing to leave:

May we contact your previous employer? Yes No

Supervisor:

Name:

Title:

Phone Number:

Employment References

1.

Name:

Address / Phone:

Occupation:

2.

Name:

Address / Phone:

Occupation:

3.

Name:

Address / Phone:

Occupation:

Verification

Personal Information

Miscellaneous

Employment Interests / Skills

Education

High School

College, Graduate, Business, Vocational, or Other Training

Employment History

1. Current or Most Recent Employment

2.

3.

4.

Employment References

1.

2.

3.

Thank You for submitting your application to The Black-eyed Peas Restaurants.

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