Basic Info Items marked with an asterisk are required. Name (Last, First, Middle)* Phone Number* Email Address* Address City State Zip Code Position you are applying for Choose…ManagementServerBus Person/SetupBartenderHost/GreeterEvent CoordinatorKitchenOffice/SalesMaintenanceOther I am applying for a: Full-time PositionPart-time PositionSeasonal Position Are you over the age of 18? Yes No If "No," please provide your date of birth. MonthJanuaryFebuaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day12345678910111213141516171819202122232425262728293031 Year20042003200220012000199919981997199619951994 If hired, what date can you start work? Education Highest Grade Completed Type of Degree/Certificate Date of Completion High/Trade School Name & Location 9 10 11 12 College Name & Location 1 2 3 4 Employment History Employer’s Name, Address, Phone# Dates Started-Ended Your Position Supervisor Wage Reason for Leaving Personal Data Are you authorized to work in the USA? Yes No Have you ever been convicted of a crime? Yes No If yes, what crime and where? Do you have reliable transportation to and from work during hours when public transportation might not be available? Yes No Do you smoke? Yes No Do you have any allergies, physical or mental ailments which would interefere with the preformance of your duties? Availability Choose "Yes," "No," or "Maybe" for the shifts that you can work, cannot work, or might be able to work/have limited availability to work, respectively. If "No" or "Maybe" is marked, please give a brief explanation in the box below. Shifts Monday Tuesday Wednesday Thursday Friday Saturday Sunday 11 am – 6 pm Y N M Y N M Y N M Y N M Y N M Y N M Y N M 5 pm – 12 am Y N M Y N M Y N M Y N M Y N M Y N M Y N M If "No" or "Maybe" is marked, please give a brief explanation: Does your availability change due to school schedule? If so, when?