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Personal Information

Name:

Email:

Phone:

Cell Phone:

Address:

City:

State:

Zip:

Please answer the following questions

Do you have reliable transportation?

Yes No

Have you ever been convicted of a crime?

Yes No

If yes, please describe:

How were you referred to us?

Position you are applying for

Position of Interest:

Location (select all that apply)

Hanover Street Chophouse
C.R. Sparks Restaurant
The Event Center
Any Location

Salary Requirement:

$ per

I prefer to work (check one) Full time Part time Seasonal Hours per week

List below the times per day you ARE available to work:

Sunday

Thursday

Monday

Friday

Tuesday

Saturday

Wednesday

Work Experience

(Start with most recent position)

Company:

Job Title:

Reason for leaving:

Start Date / End Date

Starting Salary
$ per

Ending Salary
$ per

May we contact the company? Yes No

Supervisor:

Title:

Address:

City:

State:

Zip:

Phone:

List responsibilities and accomplishments:

Company:

Job Title:

Reason for leaving:

Start Date / End Date

Starting Salary
$ per

Ending Salary
$ per

May we contact the company? Yes No

Supervisor:

Title:

Address:

City:

State:

Zip:

Phone:

List responsibilities and accomplishments:

Company:

Job Title:

Reason for leaving:

Start Date / End Date

Starting Salary
$ per

Ending Salary
$ per

May we contact the company? Yes No

Supervisor:

Title:

Address:

City:

State:

Zip:

Phone:

List responsibilities and accomplishments:

Education

High School:
City:
State:
Major:

Years Completed


1	2	3	4

Graduated: Yes No

College:
City:
State:
Major:

Years Completed


1	2	3	4

Graduated: Yes No

Other Training, certifications, etc (i.e. Team, servsafe)

Why would you be a good choice for the position?

Please Read:

I certify that the information above is complete and accurate to the best of my knowledge. I authorize the individuals, companies, and agencies concerned to provide the Premier Companies and its agents with all information necessary to verify the statement I have made in this application, and I release them from any liability for so doing. I further understand that any offer of employment is contingent upon proof of my identity and documentation of my right to work. I understand that these policies cannot be changed except in writing.

Name: - Date: