Application for Employment

Name(Required)

First Last

Email(Required)

Current Address(Required)

Street Address Address Line 2 City State ZIP Code

Permanent Address

Street Address Address Line 2 City State ZIP Code

Phone (mobile)

Are you under 18 years of age?(Required)

Yes

No

Birth Date(Required)

Are you eligible to work in the United States?(Required)

Yes

No

Have you worked at any of our sister companies?(Required)

Yes

No

(Duluth Grill, OMC Smokehouse, Corktown Deli & Brews, Burger Paradox, Goat Hill Marketplace, or Minnesconsin Merch)

Describe your relevant work experience

If hired, do you have reliable transportation to and from the location you are applying to?(Required)

Yes

No

Explain your transportation capabilities:(Required)

Emergency Contact(Required)

First Last

Emergency Contact Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Emergency Contact Phone(Required)

Are you a military veteran?

Yes

No

Employment History

Employer #1 Name & Location

Employer #1 Date Hired

Employer #1 Date Ended

Employer #1 Job Duties

Reason for Leaving Employer #1

May we contact employer #1?

Yes

No

Employer #2 Name & Location

Employer #2 Date Hired

Employer #2 Date Ended

Employer #2 Job Duties

Reason for Leaving Employer #2

May we contact employer #2?

Yes

No

References

List persons not related to you as references, whom you have known for at least one year.

Reference #1 Name

First Last

Reference #1 Phone

Reference #1 Years Acquainted

Reference #1 Relationship

Personal

Business

Reference #2 Name

First Last

Reference #2 Phone

Reference #2 Years Acquainted

Reference #2 Relationship

Personal

Business

Additional References (if any)

Are you known to schools/references by another name?

Yes

No

Other Name

First Last

Agree to Terms Before Submitting Application

1. I authorize investigation of all statements contained on this application except where I have requested on this form that no investigation be made. 2. I understand that misrepresentation or omission of facts called for is cause for dismissal and that my employment is substantially dependent on truthful answers to the fore going inquires. 3. I understand that nothing contained in this employment application or in the granting of an interview is intended to nor does it create an employment contract between the company and myself for either employment or the providing of any benefit. In the event that an employment relationship is established, I understand that I have the right to terminate my employment at any time for any reason, and the company retains the same right regarding the discontinuation of my employment.

Authorization(Required)

I understand and agree to the above provisions

It is Duluth Grill family policy that no employee or applicant will be discriminated against because of race, gender, sexual orientation, marital status, color, religion, disability, veteran status or any other characteristic protected by federal, state, or local law. Employment decisions are based on merit, qualifications, and abilities.

Education

Employment Desired

Employment History

References

Agree to Terms Before Submitting Application