Legal Name *

First Name

Last Name

Preferred Name (if different than legal name)

First Name

Last Name

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone *

(###)

###

####

Position *

Check all that apply

Host/Server

Baker/Assistant Baker

Cook/Prep

Dishwasher

Availability *

Check all that apply. Please note that candidates with more availability will stand out more in the hiring process.

Full Time (30-40 hours)

Part Time (10-29 hours)

Weekends

Weekdays

Mornings

Afternoons

Can you reliably lift up to 50 pounds, stand for long periods, and work in a fast-paced kitchen/counter environment? *

Yes

No

Are you authorized to work in the United States on an unrestricted basis? *

Yes

No

Have you ever been convicted of a felony? *

Convictions will not necessarily disqualify an applicant for employment.

Yes

No

How many years have you worked in a food service or retail setting? *

0-1 Years

1-3 Years

3-5 Years

5+ Years

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

May we contact this employer?

Yes

No

Employer Phone Number

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

May we contact this employer?

Yes

No

Employer Phone Number

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

May we contact this employer?

Yes

No

Employer Phone Number

(###)

###

####

Name *

First Name

Last Name

Phone *

(###)

###

####

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the Employer to make an investigation of any of the facts set forth in this application and release the Employer from any liability. The employer may contact any listed references on this application. *

Yes

No

I acknowledge and understand that the company is an “at will” employer. Therefore, any employee (regular, temporary, or other type of category employee) may resign at any time, just as the employer may terminate the employment relationship with any employee at any time, with or without cause, with or without notice to the other party. *

Yes

No

Electronic Signature *

Type your name below to sign.

First Name

Last Name

Today's Date *

MM

DD

YYYY