Tell Us About Yourself...

Your Name:
    

Position Desired:
    

Referred By:
    

E-Mail Address:
    

Phone Number w/ Area Code:
    

Street Address:
    

City: , State: ZIP:

Gender:
     Select a gender... male female

Are you 16 years of age or older?:
     Select an answer... yes no

Have you ever been employed by this company before?
     Select an answer... yes no

If, yes, when and where?
    

Supervisor's Name:
    

Are you currently employed?
     Select an answer... yes no

If, yes, where, and what hours?
    

What is your level of schooling?
     Select a grade/level... 9 or less Some High School Completed High School or GED Some College Associates Degree Bachelors Degree Some Trade or Vocational Schooling Trade or Vocational Certificate

Are you currently enrolled in school?
     Select an answer... yes no

If, yes, where, and what hours?
    

What is your major?
    

Have you served in the military?
     Select an answer... yes no

Will you work nights and weekends?
     Select an answer... yes no

For what shifts are you available?
    

Former Employer #1
Business Name:
    
Telephone Number:
    
Dates Worked:
    
Position:
    
Supervisor:
    
Reason for Leaving:
    

Former Employer #2
Business Name:
    
Telephone Number:
    
Dates Worked:
    
Position:
    
Supervisor:
    
Reason for Leaving:
    

Former Employer #3
Business Name:
    
Telephone Number:
    
Dates Worked:
    
Position:
    
Supervisor:
    
Reason for Leaving:
    

Personal Reference #1
Name:
    
Telephone Number:
    
Address:
    

Personal Reference #2
Name:
    
Telephone Number:
    
Address:
    

Personal Reference #3
Name:
    
Telephone Number:
    
Address:
    

Please list any restaurant experience (jobs performed / special abilities):
    

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