Basic Employment Application Form

Employment Application

Wake Cafe is an equal opportunity employer. Applicants will be considered regardless of race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services, and employment is available to all individuals. Applicants requiring accommodations to the application and/or interview process should contact the Human Resource Representative.

Each question should be answered completely and accurately.

No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.

Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail

Confirmation Email

Position(s) Applying For:

Wage expectations per hour

Referral source

Are you over the age of 18?

Are you eligible to work in the United States?

Are you fluent in a foreign language?

If yes, what language(s)?

Are you currently employed?

Date available for work

MonthDayYear

Are you available to work?

Have you applied here before?

If yes, give date:

Have you been convicted of a felony/misdemeanor (other than traffic violations)?

If so, provide the location, date and result/outcome for each conviction:

EDUCATION

Highest level of education completed:

Please complete the appropriate sections

Rows	Name & Location of School	Number of Years Attended	Did You Graduate?	Degree or Certification
GED / High School
Trade School
College
Graduate

WORK HISTORY

Please list your four most recent employers, list the most recent first

1. Employer

Employer's Name (Most current)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

2. Employer

Employer's Name (Second most recent)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

3. Employer

Employer's Name (Third most recent)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

4. Employer

Employer's Name (Fourth most recent)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

ADDITIONAL INFORMATION

Do you have a U.S. military service record?

Click to edit

If yes, branch of service

Discharge date and rank

List job-related accomplishments, projects, and awards. (Exclude information that would reveal race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status.)

List any additional information you would like us to consider:

Employment Application

Wake Cafe is an equal opportunity employer. Applicants will be considered regardless of race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services, and employment is available to all individuals. Applicants requiring accommodations to the application and/or interview process should contact the Human Resource Representative.

Each question should be answered completely and accurately.

No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.

By entering your name, you agree to accept the terms of the above document with an electronic signature.

You must agree to accept the terms of the document in order to submit an application.

Type signature

Date

MonthDayYear

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