* denotes a required field.
What position(s) are you applying for?*
Address Line 1:
Address Line 2:
Applicant's Phone Number*
Are you at least 16 years old?*
Are you at least 18 years old?*
List outside activities*
Outside activities include...
Type of employment desired*
Full TimePart Time
Number of hours available to work each week*
Do you have any commitments to another employer that might affect your employment with us?*
Are you legally eligible for employment in this country?*
Have you ever worked for this company before?
Does this company employ any of your relatives?*
Yes (List names and relationship in box below)No
Relatives employed include...
Have you ever been convicted of a crime, excluding misdemeanors and traffic violations? *
Yes (Describe in full in box below)No (Move on to next question)
What is the last grade in high school that you completed?*
8 or less9101112GED
Name and location of high school*
What was the last year of college, tech, or business school that you completed (if any)?*
If you attend / attended college, tech, or business school, What is your major course of study?
What school activities / organizations including athletics, did or do you participate in?*
Information must be complete and accurate. Give present or most recent position first (if any).
Company Phone Number:
Position Held and Rate of Pay:
Supervisor's Name and Title:
Can we contact this employer?:
Major responsibilities include...
Reasons for Leaving:
Reasons for leaving include...
Next most recent employer (if any)
Evening and weekend hours are required.
We do not hire for specific shifts or hours.
Applicant must be available for different shifts each week.