Are you legally able to work in the U.S? YES or NO

Have you ever been convicted of a crime? YES or NO

Have you been in a motor vehicle accident in the past 7 years? YES or NO     

Do you have your own transportation? YES or NO

Do you feel comfortable speaking to a group? YES or NO

Can you drive a standard? YES or NO

Do you have cashier experience? YES or NO                  

Do you know how to operate a computer? YES or NO

Have you worked in food service before? YES or NO

School most recently attended (High School, College, etc)

Name

Location

Last Grade Completed Major

Graduated or still enrolled?                

______________________________________________________________________________________

Employment:  Please list your last two jobs, starting with the most recent.

Employer

Address

Phone number Supervisor’s Name

E-mail address

Position held

Can we contact them YES or NO How long employed

Reason for leaving

Employer

Address

Phone number Supervisor’s Name

E-mail address

Position held

Can we contact them YES or NO How long employed

Reason for leaving  

______________________________________________________________________________________

Personal  References:

Name Phone number

E-mail

Relationship to applicant Years known

Name Phone number

E-mail

Relationship to applicant Years known       

_______________________________________________________________________

Professional  References: Do not include family members. 

Name Phone number

E-mail

Relationship to applicant Years known

Name Phone number

E-mail

Relationship to applicant Years known       

______________________________________________________________________________________

To help us get to know you better, please complete the following.

How would you describe yourself?

What types of work do you enjoy doing?

What activities do/did you enjoy most in school?

What classes do/did you enjoy most in school?

What type of experience do you have with children?

What type of experience do you have with animals?

What words or phrases from the list below best describe you?  Put a check beside each that apply.

Analytical    Patient    Bottom line    Life of the party

Bubbly    Generous    Kind    Reserved Quiet

Referred by  

If you have any other skills or experience with children, animals or people list below.

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