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Application
General Information
Employment Information
First Name
Middle Initial
Last Name
Address
Address Line 1
Address Line 2
City
State
Zip Code
Email
Phone/Mobile
What position(s) are you applying for?
Server
Bartender
Cook
Barback / Dishwasher
Management
Date Available to Start
If hired, will you be able to work overtime?
Yes
No
Are you able to perform the essential job functions of the position you are applying with reasonable accommodations?
Yes
No
Are you at least 18 years of age?
Yes
No
If under 18, do you have a work permit?
Yes
No
Are you legally eligible to work in the United States?
Yes
No
Do you have reliable transportation?
Yes
No
What are your minimum expected earnings?
Please tell us more about yourself and why you would make a great employee (350 characters max)?
Do you prefer to work days, afternoons or nights?
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Days
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Nights
What days of the week are you available to work?
Mon
Tues
Wed
Thur
Fri
Sat
Sun
Can you work holidays?
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No
Fulltime or Partime
Fulltime
Part
Are you willing to work a changing schedule?
Yes
No
Occasionally
Did you graduate high school or attain GED equivalent?
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.
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Explanation
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Current/Most Recent Employer
Title/Position
Employer Location
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State
Is this your current employer?
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Start Date
May we contact this employer for references?
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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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