Work at Cabaret!

First Name

Middle Initial

Last Name

Social Security Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Phone/Mobile

Date Available to Start

Fulltime, Partime, Temp, or Permanent

What days and hours can you work?

Are you able to peform the essential job functions of the position you are applying with or without reasonable accommodations?

Yes

No

If hired, will you be able to work overtime?

Yes

No

Are you at least 18 years of age?

Yes

No

If under 18, do you have a work permit?

Yes

No

Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged or sealed by court? A yes response does not automatically disqualify your application. If yes, please explain.

Yes

No

Explanation

High School

College

Additional Schooling

City

State

City

State

City

State

Degree/Diploma

Date Graduated

Other Special Knowledge, Skills or Qualifications (list any construction or manufacturing equipment, office skills, technical equipment or training)

Military Service (list dates, ranks and training)

Do you type? (For Clerical Applicants Only)

Yes

No

Words Per Min Typed

ComputerSkills (hardware/software)

Current/Most Recent Employer

Title/Position

Employer Location

City

State

Is this your current employer?

Yes

No

Start Date

May we contact this employer for references?

Yes

No

End Date

Starting Salary

End Salary

Supervisor Phone #

Supervisor Name

Job Duties and Responsibilities

Reason for Leaving

Employer 2

Title/Position

Starting Salary

Start Date

End Salary

End Date

Supervisor Phone #

Supervisor Name

Job Duties and Responsibilities

Reason for Leaving

Employer 3

Title/Position

Starting Salary

Start Date

End Salary

End Date

Supervisor Phone #

Supervisor Name

Job Duties and Responsibilities

Reason for Leaving

Employer 4

Title/Position

Starting Salary

Start Date

End Salary

End Date

Supervisor Phone #

Supervisor Name

Job Duties and Responsibilities

Reason for Leaving

Volunteer Activities (list organization, type of service, dates)

Hobbies/Interests (optional)

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