| Please fill this application out as accurately and fully as possible. All items with a * are required fields. | |
| Full Name * | |
| Name you prefer to be called (or Nickname) | |
| Street Address | |
| City | |
| State | |
| Zip Code | |
| Home Phone | - - |
| Mobile Phone | - - |
| Are you either a U.S. citizen or an alien authorized to work in the U.S.? * |
Yes No |
| Are you at least 16 years of age or over? (note: at this time Carriage Crossing is not hiring anyone under the age of 16.) * |
Yes No |
| What is the PRIMARY position for which you are applying? * |
Server Host Line Cook Prep Cook Dishwasher Pie/Bread Baker Gift Shop |
| What is your SECOND choice of positions? |
Server Host Line Cook Prep Cook Dishwasher Pie/Bread Baker Gift Shop NO SECOND CHOICE |
| Date you can start work. * |  |
| Salary / Wage Desired * | |
| Are you employed now? * |
Yes No |
| If so, may we contact your present employer? |
Yes No |
| Have you worked for Carriage Crossing or Dutch Kitchen before? * |
Yes No |
| If so, when? | |
| ----- EDUCATION INFORMATION ----- | |
| Name and location of high school | |
| Years Attended | |
| Did you graduate? |
Yes No |
| Subjects Studied | |
| Name and location of college / university | |
| Years Attended | |
| Did you graduate? |
Yes No |
| Subjects studied | |
| Name and location of business or trade school | |
| Years Attended | |
| Did you graduate? |
Yes No |
| Subjects Studied | |
| ----- EMPLOYMENT HISTORY ----- | |
| List below your last three employers, starting with the most recent first. | |
| Employer 1 Name and Location | |
| Start Date | |
| End Date | |
| Rate of Pay | |
| Position / Duties | |
| Reason for Leaving | |
| Employer 2 name and location | |
| Start Date | |
| End Date | |
| Rate of Pay | |
| Position / Duties | |
| Reason for leaving | |
| Employer 3 name and location | |
| Start Date | |
| End Date | |
| Rate of pay | |
| Position / Duties | |
| Reason for leaving | |
| U.S. Military Service, Dates, Rank | |
| ----- REFERENCES ----- | |
| Give the names of three persons not related to you, whom you have know for at least one year. | |
| Reference 1 Name | |
| Contact Info | |
| Business | |
| Years Acquainted | |
| Reference 2 Name | |
| Contact Info | |
| Business | |
| Years Acquainted | |
| Reference 3 Name | |
| Contact Info | |
| Business | |
| Years Acquainted | |
| ----- AVAILABILITY ----- | |
| Carriage Crossing employees work on a set schedule. Your schedule will be based on the information you supply here. | |
| MON Breakfast & Lunch * |
Yes No |
| TUES Breakfast & Lunch * |
Yes No |
| WED Breakfast & Lunch * |
Yes No |
| THURS Breakfast & Lunch * |
Yes No |
| FRI Breakfast & Lunch * |
Yes No |
| SAT Breakfast & Lunch * |
Yes No |
| MON Dinner * |
Yes No |
| TUES Dinner * |
Yes No |
| WED Dinner * |
Yes No |
| THURSDAY Dinner * |
Yes No |
| FRI Dinner * |
Yes No |
| SAT Dinner * |
Yes No |
| ABOUT YOURSELF: What sports, activities, hobbies do you enjoy? | |
| I have read and agreed to the statements below regarding truth in application, investigation of my statements and period of employment. * |
Yes No |
| Please type the code shown in the image: * | |
Truth in Application Statement: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 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 all parties from all liability for any damage
that may result from furnishing same to you. I
understand and agree that, if hired, my employment is for no definite
period and may, regardless of the date of payment of my wages and salary,
be terminated at any time without prior notice.
|