Personal Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

Position Applying For *

Waitress/Waiter

Cashier

Cook

Dishwasher

Are you legally authorized to work in the United States? *

Yes

Have you ever been convicted of a felony? *

Yes

If yes, please explain.

Availability

Type of Employment *

Temporary

Seasonal

Part-Time

Full-Time

Time Availability *

Employment and Education History

Employer 1

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact?

Yes

Phone Number

Employer 2

Company Name

Address

Phone

Start Date +

End Date +

Position

Salary

Supervisor/Manager

Reason for Leaving

May we contact?

Yes

Phone Number

High School Education

Name of School *

Graduation Month/Year * +

Secondary Education

Did you attend? *

Yes

Name of School

Graduation Month/Year +

References

Reference 1

Name

Title

Email Address

Phone

Reference 2

Name

Title

Email Address

Phone

Please submit a copy of your resume.

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