Employment Application

Applicant Information

Last name

First name

Date of birth

Street Address

Apartment/Unit #

City

State

Zip Code

Phone Number

If under 18 years of age, can you submit a work permit?

Yes No I'm 18+

Are you authorized to work in the U.S.A?

Yes No

English Proficiency?

None Basic Good

Spanish Proficiency?

None Basic Good

Manager Cook Line Cashier Dishwasher

Past experiences in this position (optional)

Other related experiences (optional):

Please select what time you will be available each day of the week. If you want to skip a day just don't select it