First name
Last name
Positions Interested In ServerBusserBartenderManagerDishwasherLine CookPrep Cook
Location(s) Amherst (Sheridan Dr)Williamsville (Eastern Hills Mall)Depew (Dick Rd)Orchard Park (Orchard Park Rd)Niagara Falls (Niagara Falls Blvd)
Your Address
City
State/Province
Zip/Postal Code
Country
Telephone
Email
Date Available to Start
If you are under 18 can you provide a work permit? YesNo
If not please explain:
Are you legally allowed to work in the United States? YesNo
Type of employment desired Full TimePart TimeSeasonalTemporary
Have you ever pleaded guilty, no contest or been convicted of a crime? YesNo
If yes, please explain:
Name and Location of High School:
Status Currently AttendingGraduatedDid Not Graduate
Name and Location of College
Years Attended
Degrees Completed/In Progress
Other Subjects Studied
Trade, Business or Correspondence School
Subjects Studied
Summarize your special skills or qualifications:
Daytime Availability (11AM - 5PM) MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Nighttime Availability (5PM - 12AM) MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Prevous Employment (begin with most recent position, provide company name, position, pay, etc.)
Signature of Applicant
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal state laws."
Date
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