John and Mary’s: Arcade, NY Application for Employment Legal Name: * First Name Last Name Phone Number: * (###) ### #### Email Address: * Address: * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth: * MM DD YYYY Working papers: * I am under 18 and I have my legal working papers. I am over 18. Have you applied here before? * Yes No Position applying for: * Cashier/Server Dishwasher Cook Delivery Driver Any Desired pay: * Are you currently employed? * Yes No Have you ever been convicted of a felony? * Yes No You may be required to lift up to 40lbs, will that be a problem? * Yes No Available start date: * MM DD YYYY What days of the week are you available to work? * Monday Tuesday Wednesday Thursday Friday Saturday Sunday What shifts are you available to work? * AM shifts PM shifts Both AM and PM shifts Please add any additional information about your availability or scheduling here: Education history: * INCLUDE: School Names, Location, Years completed and any degrees/diplomas. Previous Employment: * Please list the last 5 years of employment. INCLUDE: Company Name, Manager Name, Dates of Employment and reason for leaving. References: Please give information for 2 references below. Reference 1 Name: First Name Last Name How many years have you known this person? Reference 1 Phone Number * (###) ### #### Relationship to you: Reference 2 Name: * First Name Last Name Reference 2 Phone Number: * (###) ### #### How many years have you known this person? Relationship to you: Current Date: * MM DD YYYY Thank you for submitting your Application for Employment at John and Mary’s - Arcade, NY!
