Employee Application

Application for Employment

"*" indicates required fields

Step 1 of 10 - Name

Last Name*

First Name*

Middle Initial*

Social Security Number*

Street Address*

City*

State*

Zip Code*

Email*

Phone*

Yes - U.S. Citizen

X Yes, I am a U.S. Citizen

Employment is conditional upon you completing Form I-9 and providing documents establishing your identity and authorization to work in the U.S.

No - U.S. Citizen

X No, I am not a U.S. Citizen

Yes - I am 18 years of age

X Yes, I am 18 years of age

No - I am not 18 years of age

X No, I am not 18 years of age

If under the age of 18, applicant will be required to submit a work certificate as required by State or Federal law.

Have you ever plead “guilty”, “nocontest”, or been convicted of a crime?

X Yes

X No

Where and When?*

Description of Offense*

Position you are applying for*

DO NOT WRITE: (General, Open or Any Available)

Desired Wage*

If a wage was listed with a job listing, please enter that amount here, or you may enter your desired wage.
Current minimum wage is $9.30 per hour for tipped employees, (waitstaff and bussers will be paid this wage) and $12.32 for non-tipped employees, (dish staff, prep-cooks, hostess, food runners and bar tenders will be paid this wage).

Previous Employer

Employed from:

Employed to:

Position Worked

Reason for Leaving

Reference Name 1

Reference Relationship 1

Reference Phone 1

Do you have a second reference?*

Yes

No

Reference Name 2

Reference Relationship 2

Reference Phone 2

Email

This field is for validation purposes and should be left unchanged.

Application for Employment

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