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Employment Application
Employment Application
Silver Star Saloon
Step
1
of
5
20%
Personal Information
Application Date
*
MM slash DD slash YYYY
Name
*
First
Middle
Last
Current Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone Number
Email Address
*
If hired, can you provide evidence of legal eligibility to work in the U.S.?
*
Yes
No
Any offer of employment is conditioned upon completing form I-9 and providing the appropriate documents for identity and work authorization.
Position Desired
*
Wage/Salary Desired
Full Time?
Yes
No
Part Time?
Yes
No
Date you can begin work
MM slash DD slash YYYY
Are you 18 years or older?
Yes
No
If under 18 years of age, you will be required to submit a birth certificate or work certificate as required by state or federal law
Educational History
Name of High School attended
City/State
Did you graduate?
Yes
No
GED?
Yes
No
Name of college or technical school
City/State
Degree?
Yes
No
Major
Are you presently enrolled in school?
Yes
No
If yes, give name & address of school and expected degree date:
List any job-related skills or accomplishments, including military service
Your Availability for Work
Monday
List From: and To: times
Tuesday
List From: and To: times
Wednesday
List From: and To: times
Thursday
List From: and To: times
Friday
List From: and To: times
Saturday
List From: and To: times
Sunday
List From: and To: times
Total hours per week you are available to work
Do you have any special requests or needs for a work schedule?
Provide three references who are not former employers who we may contact
Reference 1
Name and Occupation
How do you know them, and for how long?
Phone Number
Reference 2
Name and Occupation
How do you know them, and for how long?
Phone Number
Reference 3
3. Name and Occupation
How do you know them, and for how long?
Phone Number
Your Employment History
List names of employers with present or last employer listed first
May we contact current employers before you are offered a position?
Yes
No
1. Name of Employer
Job Title
Dates of Employment (From: and To:)
Employer Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Duties
Name of Supervisor
First
Last
Phone Number
Reason for Leaving
Starting pay
Ending pay
2. Name of Employer
Job Title
Dates of Employment (From: and To:)
Employer Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Duties
Name of Supervisor
First
Last
Phone Number
Reason for Leaving
Starting pay
Ending pay
3. Name of Employer
Job Title
Dates of Employment (From: and To:)
Employer Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Duties
Name of Supervisor
First
Last
Phone Number
Reason for Leaving
Starting pay
Ending pay
*
I have read and understood all of this application.
Date
*
MM slash DD slash YYYY
Signature or Typed for Digital Application
*
CAPTCHA
20384
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