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?
Last day you are available this season?
If you are under 18, can you furnish a work permit?	- Choose an Option - Yes No I am over 18
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
Current Employer (If Applicable)
Phone No. with Area Code
Address
Start Date
End Date
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
Job Title
Supervisor's Name & Title
Describe duties briefly
Specific reason for leaving

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

Resume
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Requested Information
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