Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

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

Yes

No

Position or type of employment desired. *

Server

Bus Boy

Bartender

KitchenAid

Other ______________________________________________________

Are you willing to work weekends and holidays? *

Yes

No

Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodations? *

Yes

No

Education Highschool *

9

10

11

12

Highschool applicants: Do you have an active working permit?

If not, please obtain a working permit from your high school and turn it in with your application.

Yes

No

Are you bilingual? *

Yes

No

Have you been convicted of any felonies other than minor traffic violations during the past seven years (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying).

Yes

No