L&D Development, Inc./J. Fargoʼs Family Dining & Micro Brewery
APPLICATION FOR EMPLOYMENT
We are an equal opportunity employer
Questions marked by * are required.

1.
DATE *
2.
EMAIL *
 
 
3. LAST NAME *
 4. FIRST NAME *
 5. MIDDLE NAME
6. STREET ADDRESS *
 7. CITY *
 8. STATE *
9. ZIP *
 10. PHONE NUMBER *
 11. CELL NUMBER
12. Employent Desired:
  • Hostess
    must be 14 years or older
  • Server
    must be 16 years or older
  • Bartender
    must be 21 years or older
  • Dishwasher
    must be 16 years or older
  • Cook
    must be 18 years or older
  • Able to serve liquor
    must be 18 years or older
 13.
Times below are estimated
Are you willing to work:
  • Day shift (9:00 am-4:00 pm)
  • Evening shift (4:00 pm-10 pm)
  • Split shifts
  • Week ends
 14. Days or Times you can NOT work
15. Salary Desired
 16. Date you can start
 17. Referred by

18. Have you worked for JFargo's before?
  • Yes
  • No
 19. What position?
 20. When?

21.
Reason for leaving?

22. Have you been convicted of a criminal offense in the past seven years?
  • Yes
  • No
 23. If "Yes" state nature of the crime:
 24. Disposition of the case:

EDUCATION Name of School Last Year
Completed 		Graduated?
25. High School Yes   No
26. College Yes   No
27. Trade, Business, VoTec Yes   No

SPECIAL JOB SKILLS
28. Specialities, job related skills (typing, drivers license, etc.)

REFERENCES
List below three persons not related to you, whom you have known at least one year.
Name City & State Phone Number Years Acquainted
29.
30.
31.

EMPLOYMENT HISTORY
List below your last four employers, starting with current or most recent first.
Date/Month/Year Name &
Phone Number 		Position Salary
upon leaving 		Reason
for leaving
32. To: 
From: 
33. To: 
From: 
34. To: 
From: 
35. To: 
From: 

APPLICANT STATEMENTS
36. I certify that the facts contained in this application (and accompanying resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation on the application is sufficient cause to refusal to hire, or dismissal if I have been employed no matter when discovered.   Yes  No
37. I authorize the Company to investigate all statements contained in my application and/or resume.   Yes  No
38. I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time.   Yes  No