Delta- Job Application

Job Application

Please complete all the sections below:
Applicant Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number( Text Message Capable?)*
Please enter a valid phone number.
Email*
example@example.com
Date of Application*
Availability: Please complete the form below representing each day of the week. If you have a conflict that day PLEASE; 1.Write the TIME YOU CAN START WORKING THAT DAY 2.Write the TIME YOU MUST END WORKING THAT DAY 3.If you are fully available with no conflict that day, write “Fully Available” 4.If you CANNOT WORK that day, Write “Off”
Friday*
Start time/ End Time/ Fully Available/ Off
Saturday*
Start time/ End Time/ Fully Available/ Off
Sunday*
Start time/ End Time/ Fully Available/ Off
Monday*
Start time/ End Time/ Fully Available/ Off
Tuesday*
Start time/ End Time/ Fully Available/ Off
Wednesday*
Start time/ End Time/ Fully Available/ Off
Thursday*
Start time/ End Time/ Fully Available/ Off
Employment Position*
Position(s) applying for: __________________. (If Uncertain, please enter “Any” as the Position Title.
How did you hear about this position?*
On what date can you start working if you are hired?*
Hourly Pay Rate desired:*
Personal Information
Have you ever applied to or worked for Delta Theater before? If yes, when?*
Do you have any friends, relatives, or acquaintances working for Delta Theater?If yes, state name & relationship:*
The Delta Theater serves Alcohol, therefore the following Age questions must be answered
Are you 21 years of age or older?*

YesNo
Are you 18 years of age or older?*

YesNo
If you are UNDER 18 years of age, can you acquire a Work Permit from your school district?*

YesNo
Are you a U.S. citizen or approved to work in the United States?*

YesNo
IF HIRED, can you provide document(s) verifying your Employment Eligibility in the United States?*

YesNo
Do you have any condition which would require job accommodations?*

YesNo
If yes, please describe accommodations required below.
Job Skills/Qualifications
Please list below any skills and qualifications you bring to the position for which you are applying:*
(Note: Delta Theater complies with the ADA and considers reasonable accommodation measures that may be necessary foreligible applicants/employees to perform essential functions.
Education and Training
High School*
Name and address
Year Graduated*
Degree Earned*
College/University*
Name and address
Year Graduated*
Degree Earned*
Vocational School/Specialized Training*
Name and address
Year Graduated*
Degree Earned*
Previous Employment

Note: If NO previous employers, simply write “No previous jobs” in the first Employer Name Box Below
Employer Name:*
Job Title:*
Supervisor Name:*
Employer Address:*
City, State and Zip Code:*
Employer Telephone:*
Dates Employed:*
Reason for leaving:*
Employer Name:*
Job Title:*
Supervisor Name:*
Employer Address:*
City, State and Zip Code:*
Employer Telephone:*
Dates Employed:*
Reason for leaving:*
References

Please provide 3 personal and/or professional reference(s) below:Note: You must provide 3. At least 1 of the 3 must be professional. (Yes. Teachers/Coaches are professionals)
Reference Name / Professional or Personal?*
Voice Contact Information (Phone Number)*
Reference Name / Professional or Personal?*
Voice Contact Information (Phone Number)*
Reference Name / Professional or Personal?*
Voice Contact Information (Phone Number)*
Additional Information:

PLEASE answer only YES or NO. Do not provide or seek additional clarification here.
Are you able to start a conversation and make eye contact with a customer who most often will be a complete stranger to you?*

YesNo
Will you be able to arrive at your shifts on time?*

YesNo
Do you understand that the theater is busiest and open most if not all weekends and holidays, and therefore you will be required to work most if not all of those days?*

YesNo
I UNDERSTAND THAT IF I AM INTERVIEWED AND HIRED BASED ON THIS APPLICATION, ANY MISREPRESENTATION
OR MATERIAL OMISSION MADE BY ME ON THIS APPLICATION WILL BE SUFFICIENT CAUSE FOR CANCELLATION OF
THIS APPLICATION OR IMMEDIATE DISCHARGE FROM THE EMPLOYERS SERVICE.
I GIVE THE EMPLOYER THE RIGHT TO CONTACT AND OBTAIN INFORMATION FROM ALL REFERENCES, EMPLOYERS,
AND EDUCATIONAL INSTITUTIONS AND TO OTHERWISE VERIFY THE ACCURACY OF THE INFORMATION CONTAINED
IN THIS APPLICATION. I HEREBY RELEASE FROM LIABILITY THE EMPLOYER AND ITS REPRESENTATIVES FOR
SEEKING, GATHERING AND USING SUCH INFORMATION AND ALL OTHER PERSONS, CORPORATIONS OR
ORGANIZATIONS FOR FURNISHING SUCH INFORMATION. THE EMPLOYER DOES NOT UNLAWFULLY DISCRIMINATE IN
EMPLOYMENT AND NO QUESTION ON THIS APPLICATION IS USED FOR THE PURPOSE OF LIMITING OR EXCUSING ANY
APPLICANT FROM CONSIDERATION FOR EMPLOYMENT ON A BASIS PROHIBITED BY LOCAL, STATE, OR FEDERAL
LAW.
THIS APPLICATION IS CURRENT FOR ONLY 90 DAYS. AT THE CONCLUSION OF THIS TIME, IF I HAVE NOT HEARD FROM
THE EMPLOYER AND STILL WISH TO BE CONSIDERED FOR EMPLOYMENT, IT WILL BE NECESSARY TO FILL OUT A
NEW APPLICATION.
IF I AM HIRED, I UNDERSTAND THAT I AM FREE TO RESIGN AT ANYTIME, WITH OR WITHOUT CAUSE AND WITHOUT
PRIOR NOTICE, AND THE EMPLOYER RESERVES THE SAME RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME,
WITH OR WITHOUT CAUSE AND WITHOUT PRIOR NOTICE, EXCEPT AS MAY BE REQUIRED BY LAW.
THIS APPLICATION DOES NOT CONSTITUTE AN AGREEMENT OR CONTRACT FOR EMPLOYMENT FOR ANY SPECIFIED
PERIOD OR DEFINATE DURATION. I UNDERSTAND THAT NO REPRESENTATIVE OF THE EMPLOYER, OTHER THAN AN
AUTHORIZED OFFICER, HAS THE AUTHORITY TO MAKE ANY ASSURANCES TO THE CONTRARY. I FURTHER
UNDERSTAND THAT ANY SUCH ASSURANCES MUST BE IN WRITING AND SIGNED BY AN AUTHORIZED OFFICER.
I UNDERSTAND IT IS THIS COMPANY’S POLICY NOT TO REFUSE TO HIRE A QUALIFIED INDIVIDUAL WITH A
DISABILITY BECAUSE OF THAT PERSONS NEED FOR A REASONABLE ACCOMODATION AS REQUIRED BY THE ADA. I
ALSO UNDERSTAND THAT IF I AM HIRED, I WILL BE REQUIRED TO PROVIDE PROOF OF IDENTITY AND LEGAL WORK
AUTHORIZATION.
I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.
Signature*

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