EMPLOYMENT APPLICATION
 Pre-Employment Questionaire
Equal Opportunity Employer

First Name:
  

Last Name:
  

Address:

City:

State:

Zip:

Phone (include area code):

Home:

(xxx-xxx-xxxx)

Work:

(xxx-xxx-xxxx)

Fax:

(xxx-xxx-xxxx)

E-Mail:

Who referred you?:

Are you currently employed?

Yes No
FORMER EMPLOYERS
 
Date Range Employer Name Position Reason for leaving
 
REFERENCES
Name Phone # Years Known

Position I am applying for:
 (check all that apply)

Server

Dishwasher

Assistant Server

Host/Hostess

Cook

Delivery Person

Additional Comments: