Career Personal Information Name* First Middle Last Phone Number*Email Address* Present Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Are You 18 Years or Older?* Yes No How Did You Hear About Our Organization? Walk In Newspaper School Referred Employment Desired Which location are you applying to?Laredo - Hwy 35Laredo - Loop 20San Antonio - La CanteraMcAllen - La Plaza MallEdinburg - TrentonCorpus Christi - La PalmeraPosition* Date You Can Start*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Hours Available to WorkFull-TimePart-TimeEitherDays Available to Work Monday Tuesday Wednesday Thursday Friday Saturday Sunday Language(s) Known* English Spanish Other U.S. Military or Present Membership in Naval Service Rank, National Guard, or Reserves Have you worked for Palenque Grill before? Yes No Agreement 1. I hereby verify that information provided is true, complete and accurate. I agree that the Company may investigate all statement made on this application form and that any misrepresentation or omission is cause for dismissal. 2. I understand that Company may review references, credit files, and criminal records as part of the employment process. 3. I understand that no employee, manager or other agent of the Company has the authority to enter into any agreement for employment for any specified period of time unless such an agreement is in writing and signed by President of Casa Palenque, Inc. I further understand that in the absence such an agreement employment can be terminated at the sole discretion of the Company employer any time. 4. I understand that this application will remain active for 30 days.
