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JOB APPLICATION
Step 1 of 7 - Personal Data
14%
Personal Information
Name
*
First
Middle
Last
Date of Birth
*
Date Format: MM slash DD slash YYYY
SSN
*
Email
*
Phone
*
Address
*
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
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
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Qualification Questions
Are you a US Citizen?
*
Select...
Yes
No
Are you authorized to work in the US?
*
N/A
Yes
No
Have you worked for Kate's Kitchen or Ronnie's Restaurant before?
*
Select...
Yes
No
When did you work here before?
*
Have you been convicted of a felony?
*
Select...
Yes
No
Describe Circumstances...
*
Position
Date Available
*
Date Format: MM slash DD slash YYYY
Position Applying For
*
Cook
Prep
Server
Bus Person
Cashier
Desired Pay
*
Education
Highest Level of Education Completed
High School
College
Trade School or Other School
High School
High School Name
*
Location or Address
*
Date(s) Attended
*
Did you graduate or complete?
*
Select...
Yes
No
Degree / Diploma / Certificate Earned
*
College
College Name
*
Location or Address
*
Date(s) Attended
*
Did you graduate or complete?
*
Select...
Yes
No
Degree / Diploma / Certificate Earned
*
Trade School or Other School
Trade School or Other School Name
*
Location or Address
*
Date(s) Attended
*
Did you graduate or complete?
*
Select...
Yes
No
Degree / Diploma / Certificate Earned
*
References
Please list two professional references.
Reference 1 Name
*
First
Last
Relationship
*
Company
*
Address or Location
*
Phone
*
Reference 2 Name
*
First
Last
Relationship
*
Company
*
Address or Location
*
Phone
*
Current/Past Employment
Please list your current or most recent employer.
Company Name
Job Title
*
Responsibilities
*
Address or Location
*
Phone
*
Supervisor Name
*
Date(s) of Employ
*
Starting & Ending Pay
*
Reason for Leaving
*
May We Call Your Supervisor for a Reference?
*
Select...
Yes
No
Add Another Past Employer?
*
Yes
No
Previous Employer 2
Company Name
*
Job Title
*
Responsibilities
*
Address or Location
*
Phone
*
Supervisor Name
*
Date(s) of Employ
*
Starting & Ending Pay
*
Reason for Leaving
*
May We Call Your Supervisor for a Reference?
*
Select...
Yes
No
Add Another Past Employer?
*
Yes
No
Previous Employer 3
Company Name
*
Job Title
*
Responsibilities
*
Address or Location
*
Phone
*
Supervisor Name
*
Date(s) of Employ
*
Starting & Ending Pay
*
Reason for Leaving
*
May We Call Your Supervisor for a Reference?
*
Select...
Yes
No
Work Availability
Can You Work Weekends?
*
Select...
Yes
No
Shifts are 6am to 4pm. Is this OK?
*
Select...
Yes
No
Do You Have Reliable Transportation?
*
Select...
Yes
No
What Weekday Commitments Do You Currently Have?
*
Disclaimer & Signature
Do You Agree With These Statements?
*
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Select...
I Agree
I DO NOT Agree
Application Date
*
Signature
*
Name
This field is for validation purposes and should be left unchanged.
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