Application

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Position & Availability

What position(s) are you applying for?*

Part-Time Server (Simulator Bays)

Part-Time Food Truck Cook

Part-Time Bartender

Date available*

Employment type desired*

Full-time

Part-time

Seasonal

Temporary

Personal Information

First name*

Last name*

Address*

Phone (primary)*

Phone (secondary)

Email*

Are you 18 years of age or older?*

Yes

Are you 21 years of age or older? (Required for bartending duties)*

Yes

Are you legally authorized to work in the United States?*

Yes

Have you previously applied to or worked for Chip Shots Payroll, LLC or Plank Road Tap Room?*

Yes

When did you previously apply / work?

Position held

Required Certifications

Do you hold a current BASSETT certification?*

Yes

BASSETT certification expiration date?

Do you hold a current Food Handler / ServSafe certification? *

Yes

Food Handler / ServSafe certification expiration date?

Education

Highest Level Completed*

When did you graduate?

School Name*

City / State*

Major / Field of Study*

Employment History

List most recent employer first. You may attach a resume in addition to completing this section.

Upload resume No file chosen

Employer 1 (Most Recent)

Employer name

Employer address

Supervisor name

Position / Title

Employment start date

Employment end date

Reason for leaving

Employer 2

Employer name

Employer address

Supervisor name

Position / Title

Employment start date

Employment end date

Reason for leaving

Employer 3

Employer name

Employer address

Supervisor name

Position / Title

Employment start date

Employment end date

Reason for leaving

Professional References

Please provide two professional references. Do not list family members.

Reference 1

Name*

Relationship*

Phone*

Years known*

Reference 2

Name*

Relationship*

Phone*

Years known*

Additional Information

Briefly describe any skills, experience, or qualifications relevant to the position you are applying for:*

Do you have any prior criminal convictions? (A conviction does NOT automatically disqualify you)*

Yes

Please describe (nature, date, outcome)

Applicant Certification & Signature

I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any false statement, misrepresentation, or omission of fact may result in disqualification from employment consideration or, if hired, immediate termination. I authorize Chip Shots Payroll, LLC to contact former employers, references, and any other sources it deems appropriate to verify the information provided herein, and I release all parties from liability in connection with the information they provide. I understand that employment with Chip Shots Payroll, LLC is at-will, meaning that either the company or I may terminate the employment relationship at any time, with or without cause, and with or without notice. I consent to a criminal background check through the Illinois State Police as a condition of my application.

Type your name to sign*

Date*

– Jobs –

Position & Availability

Personal Information

Required Certifications

Education

Employment History

Employer 1 (Most Recent)

Employer 2

Employer 3

Professional References

Reference 1

Reference 2

Additional Information

Applicant Certification & Signature