Employment

Which location would you like to work at?*

Hold down CTRL/CMD to select multiple.

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Are you 18 years of age or older?*

Are you 16 years of age or older?*

If no, can you provide a work permit?*

If hired, can you provide written evidence that you are authorized to work in the U.S.?*

EDUCATION

Add High School?

High School

School Name

Course of Study

Years Completed

Degree/Diploma

Add College?

College

School Name

Course of Study

Years Completed

Degree/Diploma

Add Technical School or Other?

Technical or Other

School Name

Course of Study

Years Completed

Degree/Diploma

EMPLOYMENT RECORD

Add Employment Experience?

Experience #1

Company Name

Position

Date Started

Date Left

Pay Rate

Reason for Leaving

Contact Person Name

First Last

Contact Person Phone

Add a 2nd Employment Experience?

Experience #2

Company Name

Position

Date Started

Date Left

Pay Rate

Reason for Leaving

Contact Person Name

First Last

Contact Person Phone

Add a 3rd Employment Experience?

Experience #3

Company Name

Position

Date Started

Date Left

Pay Rate

Reason for Leaving

Contact Person Name

First Last

Contact Person Phone

MILITARY EXPERIENCE

Add Military Experience?

Branch of Service

Date Started

Date Left

Rank and Type of Service

REFERENCES

We require 2 references. Do not include relatives. Include teachers, coaches, church leadership or previous employers.

Reference #1

Name*

First Last

Occupation*

Years Known*

Phone*

Reference #2

Name*

First Last

Occupation*

Years Known*

Phone*

Type of work desired:*

Salary desired:*

Date you can start:*

Number of hours you wish to work each week:*

Have you ever been warned, disciplined or discharged for sexual harassment, fighting, assault or attendance?*

Explain below:*

Please list any miscellaneous experience that may help you succeed in the job you are seeking:

AVAILABILITY

To be considered for most positions you must be available to work weekends (Friday, Saturday, and Sunday). Please use time options from 12:00am to 12:00pm in 30 minute increments.

Monday From:*

Monday To:*

Tuesday From:*

Tuesday To:*

Wednesday From:*

Wednesday To:*

Thursday From:*

Thursday To:*

Friday From:*

Friday To:*

Saturday From:*

Saturday To:*

Sunday From:*

Sunday To:*

MISCELLANEOUS

How were you referred to our organization?*

Other:*

Is there any information we need about your name or use of another name to check your work record?*

Please specify:*

Have you ever been convicted of a felony?*

Please specify:*

For summer help, can you work through Labor Day?*

Are you available to work during Spring Break week (1st week of April)?*

Employment

EMPLOYMENT

Employment Application (GR)

EDUCATION

High School

College

Technical or Other

EMPLOYMENT RECORD

Experience #1

Experience #2

Experience #3

MILITARY EXPERIENCE

REFERENCES

Reference #1

Reference #2

EMPLOYMENT

AVAILABILITY

MISCELLANEOUS