Select Page Join Our Team Apply Now Start a Career with the Old Town Grill and enjoy some of the best perks in the region. Above Industry Pay Weekly Pay Paid Vacations Meal Discounts Family Meal Discounts Medical Insurance Available Opportunities for Advancement Closed for 4 of July., Thanksgiving & Christmas. Application for Employment Application for Employment Personal Information NAME (LAST NAME FIRST) * SOCIAL SECURITY NO. * PRESENT ADDRESS * CITY * STATE * ZIP CODE * PHONE NO. * SECONDARY PHONE NO. EMAIL ADDRESS * REFFERED BY Employment Desired SELECT A LOCATION LONDON, KY TAZEWELL, TN CORBIN, KY Select all that apply POSITION * DATE YOU CAN START * ARE YOU EMPLOYED NOW? * YES NO IF SO, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? YES NO EVER APPLIED TO THIS COMPANY BEFORE? * YES NO WHERE WHEN Education History High School NAME & LOCATION OF SCHOOL YEARS ATTENDED DID YOU GRADUATE SUBJECTS STUDIED College NAME & LOCATION OF SCHOOL YEARS ATTENDED DID YOU GRADUATE SUBJECTS STUDIED Trade, Business, or Correspondence School NAME & LOCATION OF SCHOOL YEARS ATTENDED DID YOU GRADUATE SUBJECTS STUDIED General Information SUBJECT OF SPECIAL STUDY/RESEARCH WORK SPECIAL TRAINING SPECIAL SKILLS U.S MILITARY OR NAVAL SERVICE RANK Former Employers (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST) FROM/TO NAME & ADDRESS OF EMPLOYER POSITION REASON FOR LEAVING FROM/TO NAME & ADDRESS OF EMPLOYER POSITION REASON FOR LEAVING FROM/TO NAME & ADDRESS OF EMPLOYER POSITION REASON FOR LEAVING FROM/TO NAME & ADDRESS OF EMPLOYER POSITION REASON FOR LEAVING References GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR NAME ADDRESS BUSINESS YEARS KNOWN NAME ADDRESS BUSINESS YEARS KNOWN NAME ADDRESS BUSINESS YEARS KNOWN Authorization "I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all in􀀁 formation concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative 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, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment." In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to com­plete the required employment eligibility verification document form upon hire. Date * Signature * Your typed full name will count as a signature. Submit LONDON, KY 25 Dog Patch Trading Center London, KY 40741 606-862-1684 CORBIN, KY 14659 N US HWY 25 E #45 CORBIN, KY 40701 606-523-5515 TAZEWELL, TN 1440 N. Broad St. Tazewell, TN 37879 423-526-5766 Site by BoydTech Design Home | Menu | Rewards | OTG Challenge | Gallery | Contact | Order