Employment First Name Last Name PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Have you ever been convicted of a felony? Yes No Are you 18 or older? Yes No Are you Bi-lingual? Yes No Are you 21 or older? Yes No Desired Position(s) Wait Staff Bartender Kitchen Dishwasher Host What times can you work (Check all that apply) Days (10am-5pm Monday-Friday) Nights Weekends Full-time or Part-time? Full Time Part Time Desired Start Date MM slash DD slash YYYY EDUCATIONSchool 1 Years Attended Major Degree Received School 2 Years Attended Major Degree Received EMPLOYMENTPrevious or Current Employer 1 Dates Employed Position Work PhoneDuties Performed May we contact them? Yes No Previous Employer 2 Dates Employed Position Work PhoneDuties Performed May we contact them? Yes No Previous Employer 3 Dates Employed Position Work PhoneDuties Performed May we contact them? Yes No REFERENCESReference Name 1 Reference Employer PhoneHow do you know them? Reference Name 2 Reference Employer PhoneHow do you know them? Reference Name 3 Reference Employer PhoneHow do you know them? Optional: Attach a resume if you wishMax. file size: 16 MB.Date MM slash DD slash YYYY CAPTCHA
