Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do you have the legal right to work in the U.S.?

Yes

No

Desired Position *

Part-Time On-Site Catering Staff

Part-Time Off-Site Catering Staff

Part-Time Dishwasher

Availability *

Sunday AM

Sunday PM

Monday AM

Monday PM

Tuesday AM

Tuesday PM

Wednesday AM

Wednesday PM

Thursday AM

Thursday PM

Friday AM

Friday PM

Saturday AM

Saturday PM

Have you ever been convicted of a felony? *

No

Yes

Do you hold a valid drivers license? *

Yes

No

When are you available to begin work? *

MM

DD

YYYY

Do you have any friends or relatives that work or have worked for us? *

Yes

No

Start Date:

MM

DD

YYYY

End Date:

MM

DD

YYYY

May we contact this employer?

Yes

No

Electronic Signature *

First Name

Last Name

Date

MM

DD

YYYY