Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you 18 or older? *

Yes

No

If you are applying for a server/bartender position, are you old enough to serve or handle liquor (18yrs), and will you be able to establish that age if offered a job? *

Yes

No

Days available to work: *

Select the days you are available to work

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

To comply with Federal Law, will you be able to establish your right to work in the U.S., if offered a job? *

Yes

No

Have you ever been fired from a previous job? *

Yes

No

Have you ever been convicted of a felony in the past ten years? *

Yes

No

Are you able to perform the essential functions of the job for which you are applying? *

Yes

No

Do you now have Hepatitis A, Salmonella Typhi, E. Coli 0157:H7, or any other illness which can be spread by serving or preparing food? *

Yes

No

May we contact your present employer? *

Yes

No