Employment Application

Job Application from Website

General Information

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First Name

Middle Name

Last Name

Email

DOB (if under 21)

Address

Address Line 1

Address Line 2

City

State

Zip Code

Main Phone

Cell Phone

Have you ever been convicted of a felony which has not been annulled or sealed by court?

Yes

No

Would you willingly submit to a drug test?

Yes

No

Position(s) you are applying for

Waitstaff

Hostess

Cashier

Dishwasher

Bakery

Type of work

Full Time

Part Time

How did you hear about the job?

Hours of Availability

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Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Education

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High School

Did you Graduate?

Yes

No

GED

Major of Study

College

Did you Graduate?

Yes

No

Major of Study

Work Experience

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Company Name

Start Date

End Date

Wage Earned

Job Title Responsibilities / Duties

Reason for Leaving

Company Name

Start Date

End Date

Wage Earned

Job Title Responsibilities / Duties

Reason for Leaving

Company Name

Start Date

End Date

Wage Earned

Job Title Responsibilities / Duties

Reason for Leaving

References

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By submitting this application for employment I, certify that the facts in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements shall be grounds for dismissal.

I authorize the investigation of all statements contained in this application and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have – personal or otherwise – and release the company from all liability for any damage that may result from utilization of such information.

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