Form

Fitzy's Employment Form
Fitzy's Toowoomba P.O. Box 2057, Toowoomba QLD 4350 Ph: 07 46313 700 Fax: 07 46313755 www.fitzys.com
Full Name
First Name Last Name
E-mail
Contact Phone No:
- Area Code Phone Number

Address

Your Levels Of Education

	Name Of School	No. Year Completed	Major Or Degree
High School
College/Business/Trade School
Professional School
Other

Please Indicate If You Have A CURRENT License Or Certificate For The Following

Responsible Service Of Alcohol Responsible Service Of Gaming Gaming Licence Responsible Manager Of A Licensed Venue
If so, please indicate in which state were each of these issued?
Responsible Service Of Alcohol
Responsible Service Of Gaming
Gaming Licence
Responsible Manager Of A Licensed Venue
Have You Ever Been Convicted Of A Crime?

Yes No
If Yes, Please Explain
Do You Have A Current Drivers License?

Yes No
State Of Issue
Have You Had Any Accidents Or Moving Violations In The Last 3 Years?

Yes No
If Yes, Please Give Details
What Hours Are you Available To Work
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Availability To Work

Full Time Part Time Full Or Part Time
Previous Employment History
Employer 1
Name Of Employer
Name Of Last Supervisor

Address Of Last Employer

Phone Number Of Employer
- Area Code Phone Number
Start Date At This Employer
Day Month Year
End Date At This Employer
Day Month Year
Last Job Title
Salary
Reasons For Leaving (Be Specific)
May We Contact This Employer

Yes No
Employer 2
List The Jobs You Held, Duties Performed, Skills Used Or Learned, Advancements Or Promotions While You Worked At This Employer
Name Of Employer
Name Of Last Supervisor

Address Of Last Employer

Phone Number Of Employer
- Area Code Phone Number
Start Date At This Employer
Day Month Year
End Date At This Employer
Day Month Year
Last Job Title
Salary
Reasons For Leaving (Be Specific)
List The Jobs You Held, Duties Performed, Skills Used Or Learned, Advancements Or Promotions While You Worked At This Employer
May We Contact This Employer

Yes No
Employer 3
Name Of Employer
Name Of Last Supervisor

Address Of Last Employer

Phone Number Of Employer
- Area Code Phone Number
Start Date At This Employer
Day Month Year
End Date At This Employer
Day Month Year
Last Job Title
Salary
Reasons For Leaving (Be Specific)
List The Jobs You Held, Duties Performed, Skills Used Or Learned, Advancements Or Promotions While You Worked At This Employer
May We Contact This Employer

Yes No
References

Please List 2 References, Other Than Relatives And Previous Employers

Please List 2 References, Other Than Relatives And Previous Employers

Use This Space To Provide Any Additional Information To Describe Your Full Qualifications For The Position Which You Are Applying
Attach Your Resume
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Fitzy's Employment Form