Beach N Diner Job Application

Beach N Diner Online Job Application

Personal Information

Name:

Address:

City:

State: Zip:

Phone:

Other Phone:

Emergency Contact (Name/Phone)

Driver's License #:

Social Security #:

Email:

Employment Desired

Position:

Date you can Start:

Salary Desired:

Ever Applied to Beach N Diner Before: Yes No

If the answer above is Yes, where?

Every effort will be made to accommodate individual work schedule preferences and availability. Availability on both Saturday and Sunday is required, as well as holidays are required. Check each slot time slot you are available to work. If you are not available to work in a slot, leave it blank. You can toggle the slots off and on with your mouse button.

	Mon	Tues	Wed	Thur	Fri	Sat	Sun
8-4
4-12

Are you available to work during spring break, Christmas break, Thanksgiving weekend, summer school break and/or other vacation periods? Yes No Some

Are you available to work Friday/Saturday/Sunday night shifts?
Yes No Some

If "Some," be specific.

How many hours per week would you like to work?

Are you interested in pursuing a management position at MooTime?
Yes No

EDUCATIONAL HISTORY
High School/College	Location (city, state)	Last Grade	GPA	Grad.?


EMPLOYMENT HISTORY-1
Company Name:
Position Held:
Address:
Dates Employed: From: To:
Supervisor/Manager:
Telephone #:
Pay Rate:
Reason for Leaving:
May we contact former employer?: Yes No

EMPLOYMENT HISTORY-2

Company Name:

Position Held:

Address:

Dates Employed: From: To:

Supervisor/Manager:

Telephone #:

Pay Rate:

Reason for Leaving:

May we contact former employer?: Yes No

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 and employers 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 the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

If you agree with the statement above check the "Agree" box below and include the date.
Agree: Date: