Applicant Information
First Name
Middle
Last
Date of Birth
Email Address
Phone Number
Street Address
City
State
Zip Code

Job Details
Position(s) Applying for: (Server, Busser, Host/Hostess)
Will this be your primary job?	- Choose an Option - Yes No
When would you be able to start?
What is your last available date of work for the season?
Desired Salary
How did you find out about this job?	- Choose an Option - Employee Job Fair Newspaper Walk-in Other
Do you have reliable transportation to get to work?	- Choose an Option - Yes No
If you are under 18, can you furnish a work permit?	- Choose an Option - Yes No I am over 18
Are you legally eligible for employment in the U.S.?	- Choose an Option - Yes No
Have you been convicted of a felony? (NOTE: The existence of a criminal record does not constitute an automatic bar to employment.)	- Choose an Option - Yes No
If yes, state the nature of the offense and disposition of the case. Include dates and places.
List any special skills or training

Work History
Employer 1: Company Name
Phone No. with Area Code
Address
Start Date
End Date
Salary
Job Title
Supervisor's Name & Title
Describe duties briefly
Specific reason for leaving
Employer 2: Company Name
Phone No. with Area Code
Address
Start Date
End Date
Salary
Job Title
Supervisor's Name & Title
Describe duties briefly
Specific reason for leaving
Employer 3: Company Name
Phone No. with Area Code
Address
Start Date
End Date
Salary
Job Title
Supervisor's Name & Title
Describe duties briefly
Specific reason for leaving

Education
Secondary (select highest level achieved)	- Choose an Option - 9 10 11 12 GED None
Secondary School Name
Location
College Name
Degree & Major
Minor
Additional School History(i.e. High School and College)

Signature
I hereby certify that my answers and assertions set forth in this application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I hereby authorize this company to investigate any aspect of my prior educational and employment history. Furthermore, I understand that if I am hired, employment with this company is "at will", which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.
Date

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Requested Information
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