Online Application Applicant Information Last Name First Name Middle Initial Street Address Apartment/Unit # City State Zip Phone Other Phone E-mail Address Date Available Positions Applied For ManagementCook/PrepDishwasherServerHost/QABartender If hired, can you present evidence that you are legally able to work in the U.S.? YesNo If hired, can you submit proof of legal age to work in this state? YesNo Are of legal age to serve alcohol in this state? YesNo Are you TAP certified to serve alcohol? YesNo Do you have a Food Workers Card for Anchorage? YesNo Have you ever worked for Chili's? YesNo As an adult, have you ever been convicted of a crime, received deferred adjudication, pled no contest, or placed on probation for a crime other than minor traffic violations? YesNo Education High School Address From To Did you graduate? YesNo Past Employment Company Phone Address Supervisor Your Job Title Hourly Wage Annual Salary Responsibilities From To Reason for Leaving May we contact your current/past supervisor for a reference? YesNo By clicking Send, I certify to the best of my knowledge, the information provided in the application is correct and any false statements or omissions will justify my rejection or dismissal from employment. I authorize Peppers North LLC to conduct any necessary investigation regarding my background including: inquiries of me, current or previous employers, schools and other persons, institutions and businesses, checking motor vehicle records, court records, and criminal records as it relates to the position I am seeking to the extent permitted for federal, state, and local law. I agree to complete the requisite authorization forms for any background investigation. I hereby release all parties from any liability in connection with the provision and use of such information. If my position requires, I will agree to a drug test to be paid for by Peppers North LLC and drug tests during my employment. I understand that this application does not constitute a contract for employment or a guarantee of employment. I understand that if I am hired, my employment is "AT WILL" which means that my employment is for no definite period of time and ether Peppers North or I may terminated the employment relationship with or without cause at any time, with or without advance notice. I understand that any polices or procedures implemented by Peppers North, does not alter my "AT WILL" employment status. I understand that the company, at its sole discretion may at any time change it's personnel policies, and may also change my job description, responsibilities, wages, and benefits.