The Beach Plum - Employment Form

Date:

Name:
First Middle Last

E-Mail Address:

Present Address:
Street: City:
State: Zip Code: Country

If under 21: You must be at least 16 years old to apply
Age: Birth Date: MM/DD/1993

Phone Number: No Phone

Are you legally able to work in the United States: Yes No
(Proof of identity and legal authority to work in the U.S. is a condition of employment - Reference I-9)

For what position are you applying? (required)

Starting Hourly Wage Expected: $

How did you hear about our employment opportunities? :

Date available for employment:

Are you restricted to working?
Certain Hours: Yes No If yes, list hours/days not available:
Certain Days: Yes No If yes, list hours/days not available:

Relatives Employed by the Beach Plum:
Name: Relationship:
Name: Relationship:

(Relatives employed by the company will not necessarily exclude you from employment but will be considered for job placement to avoid a direct supervisory relationship between relatives.)

Former Employers: (list below last four employers starting with the most recent)

Date month and year (mm/dd/yy)

Name and address of employer

Reason for leaving

Employer #1

From:
To:

Departing Salary

Position

Employer #2

From:
To:

Departing Salary

Position

Employer #3

From:
To:

Departing Salary

Position

Employer #4

From:
To:

Departing Salary

Position

Name and telephone # of references

(1)
(2)
(3)

I AFFIRM THAT ALL INFORMATION IN THIS APPLICATION IS TRUE AND COMPLETE. ANY MISREPRESENTATION, FALSE STATEMENT, OR OMISSION OF FACTS CALLED FOR SHALL BE GROUNDS FOR REFUSAL OF EMPLOYMENT OR IF HIRED, DISMISSAL FROM EMPLOYMENT. I UNDERSTAND THAT ANY VIOLATION OF COMPANY RULES, POLICIES, STANDARDS, AND/OR PROCEDURES SHALL BE GROUNDS FOR DISMISSAL. I AGREE TO CONFORM TO THE RULES, POLICIES, STANDARDS, AND REGULATIONS OF THE BEACH PLUM. I UNDERSTAND THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME AT THE OPTION OF THE BEACH PLUM AND I UNDERSTAND THAT NO REPRESENTATIVE OF THE COMPANY HAS THE AUTHORITY TO MAKE ANY MODIFICATIONS, EITHER VERBALLY OR IN WRITING TO THE CONTRARY.

IT IS THE POLICY OF THE BEACH PLUM TO HIRE ONLY U.S. CITIZENS AND ALIENS WHO ARE LAWFULLY AUTHORIZED TO WORK IN THE UNITED STATES. ALL EMPLOYEES WILL BE ASKED TO VERIFY EMPLOYMENT ELIGIBILITY PRIOR TO BEGINNING WORK.

DATE __________________
SIGNATURE OF APPLICANT _______________________________

I UNDERSTAND THAT MY APPLICATION WILL REMAIN ACTIVE FOR 30 DAYS FROM THE DATE RECEIVED.

COMPLETE AND THEN SUBMIT THIS APPLICATION

The Beach Plum
17 Ocean Blvd./ POB 1076
North Hampton, NH 03862

By Submitting, your application will be sent to beachplum@thebeachplum.net