Apple Walnut Café | Application

Position(s) Desired

Date

Name

Address

Home Phone

Cell Phone

Email Address

Date of Birth

Marital Status

Means of Transportation

Emergency Contact

Relationship

Relationship Phone

Do you have experience?

How Long?

Have you ever worked in a Restaurant?

How Long?

Are you willing to work weekends?

Are you willing to work Holidays?

Do you want full or part time?

Would you start part time?

Please provide a Reference (other than family member) below:

Reference Name

Reference Phone

Are you currently attending school/classes?

If yes, where?

Hobbies/Interests

PAST EMPLOYMENT HISTORY
Please list most recent employment first

Employer 1 Name

Employer 1 Address

Employer 1 Phone

Employer 1 Supervisor

Employer 1 Reason for Leaving

Employer 1 Date Employed From

Employer 1 Date Employed To

Employer 1 Hourly Rate/Salary Starting

Employer 1 Hourly Rate/Salary Final

Employer 1 Position Held

Employer 1 Work Duties

Employer 2 Name

Employer 2 Address

Employer 2 Phone

Employer 2 Supervisor

Employer 2 Reason for Leaving

Employer 2 Date Employed From

Employer 2 Date Employed To

Employer 2 Hourly Rate/Salary Starting

Employer 2 Hourly Rate/Salary Final

Employer 2 Position Held

Employer 2 Work Duties

Agreement
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations.

Certify Above Agreement Here*

Yes

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Application

Employment Application

610-353-1384