APPLICATION FOR EMPLOYMENT GENERAL INFORMATION Name (Last)

(First)

Address (Mailing Address)

(City)

(Middle Initial)

Telephone

(

Social Security Number

(State)

(Zip)

)

-

Email

Are you legally entitled to work in the U.S.?

Yes

No

POSITION Position or Type of Employment Desired

Will Accept: Part-Time Full-Time Temporary

Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation? Yes No

Are you willing to work in a hookah environment? Yes No

Date Available

Are you 18 years of age?

Yes

No

Are you 21 years of age?

Yes

No

EDUCATION AND TRAINING High School Graduate Or General Education (GED) Test Passed? If no, list the highest grade completed:

Yes

No

College, Business School, Military (Most recent first) Name and Location

Dates Attended Month/Year

Credits Earned Quarterly or Other Semester (Specify) Hours

Graduate

From To From To From To WORK EXPERIENCE Employer

Major or Subject

Yes No Yes No Yes No

(Most Recent First) (Include military experience) Telephone Number

(

)

-

Address Job Title

Degree & Year

From: To: Hours Per Week

Number Employees Supervised

Specific Duties Hourly Wage Reason For Leaving Employer

May We Contact This Employer? Telephone Number

(

)

-

Address Job Title

Yes

No

From: To: Hours Per Week

Number Employees Supervised

Specific Duties Hourly Wage Reason For Leaving Employer

May We Contact This Employer? Telephone Number

(

)

Address Job Title

Number Employees Supervised

-

Yes

No

From: To: Hours Per Week

Specific Duties Hourly Wage Reason For Leaving

May We Contact This Employer?

Yes

No

SUPPLEMENTAL QUESTIONAIRRE Have you ever worked in a food service position before? Yes No Give an example where you excelled in your job or provided superior customer service.

On a scale of one to ten (1 = novice, 10 = expert), how do rate your knowledge or expertise on making pizzas?

1 2 3 4 5 6 7 8 9 10 Please explain:

What is your current work availability?

What makes you the right person for this job?

List and explain any felonies or misdemeanors you have been convicted or pled to in the last 6 years (excluding minor traffic violations. Conviction does not exclude you from employment.)

I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal.

Signature of Applicant_________________________________________________________ Date________________ References (Please list 3 professional references (previous employers/supervisors/managers/clients) Name and relationship to you: PHONE #: Name and relationship to you: PHONE#: Name and relationship to you: PHONE #