Host Posted on August 2, 2021August 3, 2021 738 WEST 22ND STREET, Norfolk, VA Posted 11 months ago Last Name First Name MI Address City State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zipcode Telephone (optional) Are you 18 years of age or older? Yes No Email address If you are under 18 years of age could you furnish a work permit? (optional) Choose an option Yes No Please select all that apply (optional) Management Bartender Cook Bus / Dishwasher Cashier Waiter/Waitress Host / Hostess Catering Bookkeeping Other Experience (optional) Reason for applying at Eggs Up Grill Are you currently employed? Yes No Can we contact your employer? Yes No Can you work Weekends and Holidays at 6 am? Yes No Do you have reliable transportation to work? Yes No Have you ever been convicted of a felony in the last seven (7) years? Yes No If yes, explain (optional) List hours below that you are available to work. Monday: From-To (optional) Tuesday: From-To (optional) Wednesday: From-To (optional) Thursday: From-To (optional) Friday: From-To (optional) Saturday: From-To (optional) Sunday: From-To (optional) Years Completed (optional) Choose an option 1 2 3 4 5 6 7 8 9 10 Diploma / Certificate (optional) Degree (optional) Subjects Studied (optional) Diploma / Degree / Certificate (optional) Please list your three most recent employers Name of Employer (optional) Employment Years: From-To (optional) Job Title (optional) Describe your duties (optional) Reason for leaving (optional) Starting Pay (optional) Ending Pay (optional) 2 Name of Employer (optional) 2 Employment Years: From-To (optional) 2 Job Title (optional) 2 Describe your duties (optional) 2 Reason for leaving (optional) 2 Starting Pay (optional) 2 Ending Pay (optional) 3 Name of Employer (optional) 3 Employment Years: From-To (optional) 3 Job Title (optional) 3 Describe your duties (optional) 3 Reason for leaving (optional) 3 Starting Pay (optional) 3 Ending Pay (optional) REFERENCES (optional) 1 Name (optional) 1 Occupation (optional) 1 Address (optional) 1 Phone (optional) 2 Name (optional) 2 Occupation (optional) 2 Address (optional) 2 Phone (optional) 3 Name (optional) 3 Occupation (optional) 3 Address (optional) 3 Phone (optional) Accept “I certify that all the information submitted by me on this application form is true and complete. I authorize investigation of all statements contained on this application form and permit this organization to obtain any transcripts, records, or documents pertaining to my education background or business experience. I understand that any false information, omissions, or representations are discovered, my application may be rejected or if I am employed, my employment may be terminated at any time. If any employment relationship is established, I understand I retain the right to terminate my employment at any time and that this organization retains the same right. I also understand that the terms of my employment can be changed at any time, with or without cause or notice, by this organization. I also understand that I am required to abide by all rules and regulations of this employer. I understand that Eggs Up Grill® is a registered trademark of EUG Holdco, LLC, used with permission. All rights are reserved. Each Eggs Up Grill restaurant is owned and operated by an independent franchisee. If employed, you will be employed by the franchisee that owns the restaurant and not be EUG Holdco, LLC or is affiliates.” Are you human?