Employment Application For Betty's Parkway Restaurant A separate application must be filled out for each position. Full Name __________________________ SS #________________ Telephone #_____________ Address ___________________________ City, ______________________State__________Zip _____________ Employment Desired: Server / General/Assistant Manager / Dishwasher / Cook / Kitchen Manager /Bus Person Are you over 18 years of age? Yes / No Drivers License Number________________ State_______ Do you own a vehicle? Yes No If Yes, will you drive it to work? Yes No Date you can begin:________________________ Salary Desired $____________ Have you ever applied at Betty’s before? Yes No Are you currently employed? Yes No If yes, may we contact employer? Yes No If yes, do you intend to keep that job? Yes No Explain____________________________ Are you available for work any day & any shift? Yes No If No, please explain on the back of this application. Employment Sought: Full Time Part Time Can you, at the time of employment, submit verification of your legal right to work in the United States? Yes No Have you ever pled "guilty" or "no contest" to, or been convicted of a crime? Yes No If Yes Provide dates and details on reverse side of this application. Education High School __________________ Location ________________ Graduate?_ Yes _ No College _____________________ Location ________________ Graduate?_ Yes _ No Major _________________________________________ Trade/Business/Graduate School __________________________ Location ______________ Graduate? Yes No Major_________________________ Have you ever applied or worked at Betty's Parkway before ? ______________________ Why are you interested in becoming an employee with Betty's Parkway Restaurant?____________________ What are your career goals? _____________________________________________________ Where did you get the information about the position? _________________________________ Employment History - list most recent first Company Name ___________________________ Supervisor________________ Last Position__________ Address_______________________________________________ Telephone No. ______________ City, State, Zip ____________________________ Dates of Employment ___________________ Responsibilities______________________________________________________________________________ Reason for Leaving_______________________________________________________________________ Company Name ___________________________ Supervisor________________ Last Position__________ Address_______________________________________________ Telephone No. ______________ City, State, Zip ____________________________ Dates of Employment ___________________ Responsibilities______________________________________________________________________________ Reason for Leaving______________________________________________________________________ Company Name ___________________________ Supervisor________________ Last Position__________ Address_______________________________________________ Telephone No. _____________ City, State, Zip ____________________________ Dates of Employment ___________________ Responsibilities______________________________________________________________________________ Reason for Leaving______________________________________________________________________ References - list 3 individuals [not related to you] who are familiar with your work-related skills. Name Name of Company Company Address Telephone No. Years Acquainted _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ I hereby do swear or affirm that all the information that I have provided on this application is true and accurate to the best of my ability and I have not provided any false or misleading information. Date _________________ Signature___________________________
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