Have you filed an application with
us before?
Yes No

Your Name:

Email:

Address:

City:

State:

Zip Code:

Phone Number (with area code):
  -

Email Address :

Under 21 years old? :
Yes No

If YES, date of Birth (MM/DD/YYYY)
/  /

Are you a U.S. Citizen?
Yes No

If NO, do you have a legal right to work in the U.S.?
Yes No

During the past 7 years have you ever been convicted of a crime, excluding misdemeanors and traffic violations?
Yes No
(A conviction will not necessarily bar you from employment)

Interested in (check one):
Full-time (30 or more hrs./week)
Part-time

Education (check one please):
High School Graduate
Some College
Bachelors Degree
Other (explain)

Do you have any restaurant management experience?
Yes No