Employment Application

Name*
First Last
Address*
Street Address Address Line 2 City
Cell Phone*
Other Phone
Email*
Referred By
Date You Can Start*
MM slash DD slash YYYY
Position Desired*
- Bartender
- Waitstaff
- Cook
MUST BE 21 OR OLDER TO BE CONSIDERED FOR EMPLOYMENT
Are you currently employed?*
- Yes
- No
Can we call your current employer?*
- Yes
- No
Are you legally authorized to work in the United States of America?*
- Yes
- No
Have you ever been arrested for or charged with a crime?*
- Yes
- No
Employment History*
Date Hired Date Left Name of Employer Position Salary Reason for Leaving

please list at least one employer
References*
Name Years Known Business Phone

please list at least one reference
Special Skills
Certifications
Days/Times Available
Monday
- AM
- PM
Tuesday
- AM
- PM
Wednesday
- AM
- PM
Thursday
- AM
- PM
Friday
- AM
- PM
Saturday
- AM
- PM
Sunday
- AM
- PM
Signature*

I hereby acknowledge that the information on this application is accurate and understand that providing false information is grounds for termination. I give my consent to a background check, including but not limited to criminal as a condition of employment. We are an equal opportunity employer and promote a drug-free workplace.
Email
This field is for validation purposes and should be left unchanged.

Date Hired	Date Left	Name of Employer	Position	Salary	Reason for Leaving

Name	Years Known	Business	Phone

Days/Times Available