Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Are you legally entitled to work in the United States? *

Yes

No

Have you served in the military? *

Yes (active)

Yes (no longer active)

No

Have you ever been convicted of a felony or been incarcerated in connection with a felony in the past seven years? *

Yes

No

What position(s) are you interested in applying for? *

Associate (cook, cashier, barista, back-of-house, etc...)

Assistant Manager

Weekend Manager

Other

What days are you available to work? *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

When are you available to start? *

MM

DD

YYYY

May we contact? *

Yes

No

Phone number of supervisor *

(###)

###

####

May we contact?

Yes

No

Phone number of supervisor

(###)

###

####

May we contact?

Yes

No

Phone number of supervisor

(###)

###

####

Are you currently attending? *

Yes

No

Last year of high school completed *

9

10

11

12

Are you currently attending?

Yes

No

Number of years completed

1

2

3

4

5+

Are you currently attending?

Yes

No

Name *

First Name

Last Name

Phone number *

(###)

###

####

Name *

First Name

Last Name

Phone number *

(###)

###

####