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Wendover Rainbow Logo
Montego Bay Logo


Please answer all questions. Questions marked with an * require answers.

Personal Information

Present Address Information:

Previous Address Information:

*If hired can you show proof of age?

*Have you even been convicted of a crime, other than traffic violations?

Employment Information

I wish to apply for:

*What rate of pay would you accept?

*I am available for the following shifts:

*I can start work on the following date:

*I am available for the following days:

*Have you ever worked for Peppermill/Rainbow/Montego Bay before?

*Do you have a valid drivers license?

I was referred to Peppermill/Rainbow/Montego Bay by

Health Information

*Can you perform the essential functions of the job you are applying for, with or without reasonable accommodations?

*Person to contact in case of an emergency:


Names of persons willing to provide professional and/or character reference for applicant:

Name Relationship Position


Name of School Location (City & State) Level

Work Experience

Beginning with your present and/or last position, list periods of employment(including U.S. Military Service.) Please identify and explain periods of unemployment.

Company Dates of Employment Job Description

Company Dates of Employment Job Description

Company Dates of Employment Job Description

Company Dates of Employment Job Description

Read the following statement carefully

I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by the company unless I have indicated to the contrary. I authorize the references listed above to provide the company any and all information concerning my previous employment and any pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to the company as well as from the use or disclosure of such information by the company or any of its agents, employees or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or, if I am hired, in my dismissal from employment.

In consideration of my employment, I agree to conform to the rules and standards of the company and agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of the company. I understand that no employee or representative of the company other than the president of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. Further, the president of the company may not alter the at-will nature of the employment relationship unless he does so specifically and in writing. I also understand that all offers of employment are conditioned on the provision of satisfactory proof of an applicant's identity and legal authority to work in the U.S.

My signature below certifies that I have read and understood the terms of this form. My typed name will serve as my signature for this electronic form.