Employment

Name (Required)

Phone

Email (Required)

Street

City

State/Province

Zip/Postal Code

Desired rate of pay

What position are you applying for? (Required)

How many hours would you like to work per week?

Are you willing to work overtime when hours are available?

Yes

Work references we may contact:

High School Name, Year of Graduation, Degree/Major

College Name, Graduation Year, Degree/Major

Employer

Dates of Employment

Reason for Leaving

Position & Duties

Supervisors Name/ May we Contact?

Employer

Dates of Employment

Position & Duties

Supervisors Name/ May we Contact?

Sunday 8am - 12am

Monday 11am - 12am

Tuesday 11am - 12am

Wednesday 11am – 12am

Thursday 11am – 12am

Friday 11am – 2am

Saturday 11am – 2am

Are there any days you are not available?

Do you have your own transportation?

Yes

Have you ever plead guilty or no contest to, or been convicted of any criminal offense other than minor traffic violations?

Yes

List 3 words that describe your character:

What are your strengths?

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