Request for Application - Copperhead Grille Restaurant

Personal Information

First Name

Last Name

Street Address

Apt#

City

State

Zip Code

Phone Number

Email Address

Confirm Email Address

Which location are you hoping to work at?

Center Valley

Allentown

Expected Hourly Pay Rate

Do you have reliable transportation to and from work during our hours of operation?

Yes

No

Are you applying for a full-time or part-time position?

Full-Time

Part-Time

How many hours per week do you want to work? *

What position(s) are you applying for?

Salaried Manager Cook/Line Cook Dishwasher / Prep Cook Host/Hostess Server