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Name
*
First Name
Last Name
Phone Number
*
Email
*
Which Store Location?
*
Please Select
Madison, AL (5510 Promenade Point)
Carrollton, TX (4070 State Highway 131 Suite 308)
Cupertino, CA (19700 Vallco Pkwy)
Decatur, GA (319 W Ponce De Leon Ave #10)
Duluth, GA (3330 Satellite Blvd)
Auburn, MA (385 Southbridge St)
Braintree, MA (250 Granite St)
Stoneham, MA (101 Main St)
Fort Lee, NJ (210 Main St)
Harlem, NY (17 W. 125th St)
Montclair, NJ (10 Park St)
Springfield, NJ (25 US-22 Highway)
Las Vegas (Summerlin), NV (9430 W Sahara Ave)
Las Vegas (Henderson), NV (9635 Bermuda Rd)
New York, NY (3147 Broadway)
Brooklyn, NY (413 Myrtle Ave)
Ozone Park, NY (105-02 Rockaway Blvd)
Whitestone - Bronx, NY (815 Hutchinson River Pkwy)
Providence, RI (238 Atwells Ave)
Other
Which position(s) are you applying for?
*
Host/Hostess
Server
Cook/Kitchen Staff
Management
Date available to start work
*
/
Month
/
Day
Year
Date
Are you over the age of 18?
*
Please Select
Yes
No
Authorized to work in the U.S.?
*
Please Select
Yes
No
Were you referred by someone?
*
Please Select
Yes
No
Who referred you?
Have you applied to Cap't Loui before?
*
Please Select
Yes
No
Which location?
Please Select
Madison, AL (5510 Promenade Point)
Cupertino, CA (19700 Vallco Pkwy)
Decatur, GA (319 W Ponce De Leon Ave #10)
Duluth, GA (3330 Satellite Blvd)
Auburn, MA (385 Southbridge St)
Braintree, MA (250 Granite St)
Stoneham, MA (101 Main St)
Fort Lee, NJ (210 Main St)
Montclair, NJ (10 Park St)
Springfield, NJ (25 US-22 Highway)
Las Vegas, NV (9430 W Sahara Ave)
New York, NY (3147 Broadway)
Brooklyn, NY (413 Myrtle Ave)
Ozone Park, NY (105-02 Rockaway Blvd)
Whitestone - Bronx, NY (815 Hutchinson River Pkwy)
Providence, RI (238 Atwells Ave)
Other
Were you hired?
Please Select
Yes
No
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