Application for Employment

Application for Employment
PERSONAL INFORMATION
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
EMPLOYMENT DESIRED
What Position Are You Seeking? (Click all that apply)*

ServerCookPrep CookHostDishwasherBusserBartender
What Days and Shifts Are You Available to Work? (Please click all that apply)*

Monday - Day ShiftMonday - Night ShiftTuesday - Day ShiftTuesday - Night ShiftWednesday - Day ShiftWednesday - Night ShiftThursday - Day ShiftThursday - Night ShiftFriday - Day ShiftFriday - Night ShiftSaturday - Day ShiftSaturday - Night ShiftSunday - Day ShiftSunday - Night Shift
Date You Can Start*

MonthDayYear
Wages Desired*
Are You Currently Employed?*

YesNo
Have You Ever Applied Here Before?*

YesNo
When?
Are You Legally Authorized to Work in the U.S.A.?*

YesNo
EDUCATION & TRAINING

Schools Attended*

Subjects, Areas of Studies, or Special Training
U.S. Military Service
FORMER EMPLOYMENT

Begin with most recent employer.
Employer Name
Employer Phone Number
Dates To and From
Position
Employer Name
Employer Phone Number
Dates To and From
Position
Employer Name
Employer Phone Number
Dates To and From
Position
REFERENCES

Provide the names of three persons not related to you, whom you have known at least one year.

By submitting this application, you certify that the facts contained in it are true and complete to the best of your knowledge and you understand that, if employed, falsified statements on this application shall be grounds for dismissal. You authorize investigation of all statements contained herein and the references and employers listed above to provide any and all information concerning your previous employment and pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
Should be Empty:

PERSONAL INFORMATION