Silver Dollar Bar Application

Bartender/Server Application
E-mail

Confirmation Email
Application Date

MonthDayYear
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Day Time Phone

Area CodePhone Number
Date You Are Able to Begin Work

MonthDayYear
Are You Legally Eligible to Work in the U.S.?
Are you willing to submit to a background check?
Days interested in working? (check all that apply)

Other
How Many Hours Do You Want to Work Per Week?
Positions Interested In? (check all that apply)

Other
Any additional information you'd like to share regarding positions or your schedule.
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
(1) Employer's Name (Most current)
Current or ending wage.
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
(2) Employer's Name
Current or ending wage.
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
(3) Employer's Name
Current or ending wage.
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
Please provide 3 references that are not family members.
Reference (1) Name
Relation (1)
Friend, colleague, supervisor, etc
Reference (1) Telephone

Area CodePhone Number
Reference (2) Name
Relation (1)
Friend, colleague, supervisor, etc
Reference (2) Telephone

Area CodePhone Number
Reference (3) Name
Relation (1)
Friend, colleague, supervisor, etc
Reference (3) Telephone

Area CodePhone Number
Application Disclaimer

My signature below certifies that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to hire me, or for discharge should I be hired. I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for employment. I also authorize you to request and receive such information.In consideration for my employment, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted at any time, at the company’s sole option and without prior notice to me.I also acknowledge that my employment may be terminated, or any offer or acceptance of employment withdrawn, at any time, with or without cause, and with or without prior notice at the option of the company or myself.
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Type Name
Date

MonthDayYear
Date
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Bartender/Server Application

WORK HISTORY / EXPERIENCE

Please provide 3 references that are not family members.

Application Disclaimer