TEL 508-362-3362

Name ______________________________________ date___________________ phone __________________cell__________________

 Address            ________________________________________________ city or town___________________________ zip code___________

Cir. One                                  e-mail_______________________________________ Facebook___________________________________

 Days and nights               25 hours                      35 hours                       40 hours        SOC NO# __________________________

   Enter the days you can work.

 Please check the line that you can do

 Are you 18 or older     Yes __________ NO _________ Age_______ Will you train at minimum wage     YES________  NO_______

KITCHEN PREP____              ______       COUNTER HELP _______________    WAITING ON TABLES _____________                                                                                                                                                                                              

DISHWASHER _____________          COOK ________________    DRIVER _______________ Do you have a CAR   YES                     NO ________                      

EXPERIENCE OF JOBS NAME ADDRESS TELEPHONE NO. DATE

REFERENCES NAME ADDRESS TELEPHONE NO.

SIGNATURE OF APPLICANT                     ____________________________________________________________

Comment

 Information is voluntarily and is true to the best of my knowledge all information contained on this application can be research for accuracy and errors.