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APPLICATION FOR EMPLOYMENT
200 Crain Highway North
Glen Burnie, MD 21061
(410) 768-9788
First Name: _______________________________ Last Name: ______________________________ Middle Initial: _________
Street Address: __________________________________________________________________________ Apartment: ____________
City: ____________________________________ State: ___________________________ Zip Code: ____________________________
Phone No.: ( ) _______ - __________ Cell No.: ( ) _______ - ___________ Email: _____________________________
Birth Date: __________________ Are you 18 years of age or over (proof of age or work permit may be required)? ! YES ! NO
If applying for server/bartender, are you 21 years of age or over (proof of age may be required)? ! YES ! NO
Are you legally able to work in the United States (proof of identity and legal authority to work in the U.S. required)? ! YES ! NO
Have you ever been convicted of a felony? ! YES ! NO
If YES, for what and when? _____________________________________
Have you ever worked in a restaurant before? ! YES ! NO
If YES, what position? ____________________________________
Part-Time ! Temporary
What type of position are you seeking? ! Full-Time !
What position(s) are you applying for? ! Server ! Bartender ! Line Cook ! Kitchen Staff ! Dishwasher
Are you able to meet the attendance requirement of this position? ! YES ! NO
Total available hours per week: _____________
MONDAY
TUESDAY
Date available to start work: ________________
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
List your two most recent employers, beginning with the most recent one.
Company: _____________________ Address: ______________________________________________________ Job Title: ________________
Supervisor: ________________________________
Phone No.: ( ) _______ - ___________ Wage per Hour: ________________
Date Started: ______________ Date Ended: ______________ Reason for Leaving: ____________________________________________
Company: _____________________ Address: _____________________________________________________ Job Title: ________________
Supervisor: ________________________________
Phone No.: ( ) _______ - ___________ Wage per Hour: ________________
Date Started: ______________ Date Ended: ______________ Reason for Leaving: ____________________________________________
I certify that I have read and fully completed this form and that the information contained herein is correct to the best of my knowledge. I understand that any
omission or false information is grounds for dismissal. I authorize the references listed on this application to give you any and all information concerning my
previous employment and pertinent information they may have, personal and otherwise. I under that as part of the procedure for any employment application
an investigative consumer report may be made concerning my character, general reputation, personal characteristics and mode of living. I acknowledge that I
am applying for an Equal Opportunity Employer.
_______________________________________________________________________________________
Signature
____________________________________
Date
APPLICATION FOR EMPLOYMENT 2-2.pdf (PDF, 273.9 KB)
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