* Asterisk denotes a required field

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APPLICANT INFORMATION
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Name*
Phone*
Email*
Address*
City, Zip*

How were you referred to Company?
Location Applying for:* Dallas on Walnut StCarrolltonArlingtonHoustonFort WorthThe ColonyDeep EllumEl PasoMidland (coming later)
Position(s) applying for:* Kitchen StaffServer / Bartender / HostManagement

Applying for:* Temporary WorkPart timeFull time
What days and hours are you available for work?*
If hired, on what date can you start working?
Can you work on: WeekendsEveningsOvertime
Salary / Wage desired:

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PERSONAL INFORMATION
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Have you ever applied to / worked for this Company before? YesNo
If yes, please explain

Do you have any friends, relatives, or acquaintances working for Company? YesNo
If yes, state name & relationship

If hired, would you have transportation to/from work? YesNo

Are you over the age of 18?* (All staff are required to provide a copy of their driver’s license) YesNo

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?* YesNo

If hired, are you willing to submit to and pass a controlled substance test? YesNo

Are you able to perform the essential functions of the job for which you are applying, either with
/ without reasonable accommodation? YesNo
If no, describe the functions that cannot be performed.

Have you ever been convicted of a criminal offense (felony or misdemeanor)? YesNo
If yes, please describe the crime - state nature of the crime(s), when and where convicted and
disposition of the case.

Do you speak, write or understand any foreign languages? YesNo
If yes, describe which languages(s) and how fluent of a speaker you consider yourself to be.

Do you have any other experience, training, qualifications, or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us? YesNo
If yes, please explain.

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EDUCATION, TRAINING, EXPERIENCE
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High School
Name:
Address:
City, state, zip:
Number of years completed:
Did you graduate? YesNo
Degree / diploma earned:

College / University
Name:
Address:
City, state, zip:
Number of years completed:
Did you graduate? YesNo
Degree / diploma earned:

Vocational School:
Name:
Address:
City, state, zip:
Number of years completed:
Did you graduate? YesNo
Degree / diploma:

Military:
Branch:
Rank in Military:
Total Years of Service:
Skills/duties:
Related details:

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EMPLOYMENT HISTORY
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Below, please describe past and present employment positions, dating back five years. Please
account for all periods of unemployment.
Even if you have attached a resume, this section must be completed.
Are you currently employed? YesNo
If you are currently employed, may we contact your current employer? YesNo

Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references? YesNo

Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references? YesNo

Name of Employer:
Name of Supervisor:
Telephone Number:
Business Type:
Address:
City, state, zip:
Length of Employment (Include Dates):
Position & Duties:
Reason for Leaving:
May we contact this employer for references? YesNo

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EMPLOYMENT HISTORY
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List below three persons who have knowledge of your work performance within the last four years. Please include professional references only.

Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:

Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:

Name - First, Last:
Telephone Number:
Address:
City, state, zip:
Occupation:
Number of Years Acquainted:

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