APPLICANT INFORMATION Please leave this field empty. Full Name (required) Email Address (required) Phone # (required) Address (required) Zip Code (required) Position Applied For (required) HostessWaiter/WaitressBartenderBusserCookDish Washer Date Available (required) Desired Salary (required) Are You A Citizen of the United States? (required) YESNO If No, are you Authorized to Work in the U.S.? N/AYESNO Have You Ever Worked for this Company? (required) YESNO If Yes, When? (If Not, Please Put "N/A") Have You Ever Been Convicted of a Felony? (required) N/AYESNO If Yes, explain? (If Not, Please Put "N/A") EDUCATION High School Address From To Did You Graduate? N/AYesNo Diploma College Address From To Did You Graduate? N/AYesNo Degree Other Schooling Address From To Did You Graduate? N/AYesNo Degree or Certificate EMERGENCY CONTACT INFORMATION Emergency Contact Emergency Contact Phone # PREVIOUS EMPLOYMENT Company Phone # Address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason For Leaving May We Contact You Previous Supervisor For a Reference? N/AYesNo Company 2 Phone # address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason For Leaving May We Contact You Previous Supervisor For a Reference? N/AYesNo Company 3 Phone # address Supervisor Job Title Starting Salary Ending Salary Responsibilities From To Reason For Leaving May We Contact You Previous Supervisor For a Reference? N/AYesNo ADDITIONAL INFORMATION Additional Message or Information DISCLAIMER & SIGNATURE I Certify that my answers are true and complete to the best of my knowledge. YES * If this application Leads to employment, I understand that false or misleading information in my application or interview may result in my release Signature (Please Type Your Name) Please Confirm You Are Human
