Name
*
First Name
Last Name
Current Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Permanent Address
*
Please complete, if applicable. (Ex. Parent's Address) | Include: address, city, state and zip
Cell
*
(###)
###
####
Email Address
*
Are you or your parents members of Moore's Mill Club?
*
Members, nor children of members, are not allowed to work at the club.
Can you provide verification of your current legal authorization to work in the U.S. for any employer?
*
If you are a minor, can you provide work authorization?
*
Are you of legal age to serve alcoholic beverages?
*
Have you been convicted of any criminal offense, other than minor traffic violations, within the last seven (7) years?
*
If you answered yes to the previous question, please explain. (If no, please mark N/A.)
*
Have you ever been terminated from a job?
*
If you answered yes to the previous question, please explain. (If no, please mark N/A.)
*
What type of work are you seeking?
*
Full Time
Part Time
Temporary
What position are you seeking?
*
When are you available to begin work?
*
Ex. Immediately? Spefici Date?
How did you hear about Moore's Mill Club?
*
Ex. Referred by a friend, Newspaper, Internet, Drop-in, Recruited
Have you ever been employed by Moore's Mill Club?
*
If yes, please tell us when and your position.
If offered the job, for which you are applying, are you able to perform the essential duties of this job, with or without reasonable accommodation?
*
Please select the days/shifts you ARE available to work.
*
High School
*
Include: School Name, City & State
Degree or Diploma Received (please note GED or other equivalency program is applicable)
College
*
Include: School Name, City & State
Degree or Diploma Received (please note GED or other equivalency program is applicable)
Other
Include: School Name, City & State
Degree or Diploma Received (please note GED or other equivalency program is applicable)
List any special training received that might be relevant to this position.
Include: special training, validation month/year, subject, certification
Employment History 1
*
Include: dates of employment, name and address of employer, salary/wage, position held and reason for leaving
Employment History 2
*
Include: dates of employment, name and address of employer, salary/wage, position held and reason for leaving
Employment History 3
Include: dates of employment, name and address of employer, salary/wage, position held and reason for leaving
By completing and submitting this form, you are acknowledging the above information is complete and accurate.
*
Sign and Date
First Name
Last Name
Date
*
MM
DD
YYYY
