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Employment
Please fill out the Employment Form below
Requested Information
Name:
Street Address:
City:
State:
Zip Code
Phone Number:
Email Address:
Waiter/Waitress
Host/Hostess
Bartender
Management
Cooking
Cashier
Busboy
Dishwasher
What position are you applying for?
Full Time
Part Time
Are you seeking full time or part time work?
Are there any days you are not available?
Employer #1:
Job Title:
Date Employed From:
Date Employed To:
Reason for Leaving:
Employer Phone Number:
May We Contact?
Responsibilities:
Employer #2
Job Title:
Date Employed From:
Date Employed To:
Reason for Leaving:
Employer Phone Number:
May We Contact?
Responsibilities:
Personal/Professional Reference #1 (Name, Phone, & Relationship)
Personal/Professional Reference #2 (Name, Phone, & Relationship)
Personal/Professional Reference #3 (Name, Phone, & Relationship)
Have you ever been convicted of a felony?
Have you ever been fired/terminated from any employment?
If Yes to either, please explain. If NO, please put N/A.
Date Available
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