Application for Employment
Name
*
First Name
Middle Name
Last Name
Position you are applying for:
*
Please Select
Bartender
Barback
Host
Server
Prep Cook
Line Cook
Busser
Food Runner
Drink Runner
Date Available to Start
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you eligible for employment in the U.S.?
*
Yes
No
Are you 18 years or older?
*
Yes
No
Is there anything in your background that might be construed as negative?
*
Yes
No
If selected for employment, are you willing to submit to a pre-employment drug screening test?
*
Yes
No
Back
Next
What location are you applying for?
*
Please Select
Bellflower
Corona
New Port
Orange
Puente Hills
Whittier
Huntington Beach
Back
Next
Employer #1
Name of Employer
Are you still employed here?
Yes
No
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Pay Rate
Employer's Address
Experience
Duties Performed
May we contact this employer?
Yes
No
Employer #2
Name of Employer
Are you still employed here?
Yes
No
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Pay Rate
Employer's Address
Experience
May we contact this employer?
Yes
No
Employer #3
Name of Employer
Are you still employed here?
Yes
No
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Pay Rate
Employer's Address
Experience
May we contact this employer?
Yes
No
Back
Next
Submit
Should be Empty: