Application Date:  -- mm/dd/yr

Full Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone	ex: 555-555-5555
Home Phone	ex: 555-555-5555
Mobile	ex: 555-555-5555
E-mail

Date of Birth          (ex: mm/dd/yr)

How long at current residence?

Less than 1 Year
1-3 years
3-5 years
Over 5 years

I am applying for the following position(s) at   Sheridan's  Sheridan House  (check all that apply)

Manager/Lead
Chef

Line Cook

Pantry/Salad Prep

Bartender/Barista
Server
Bus/Dishwasher
Cleaning Custodian/Maid Service

Desired Yearly Salary:  $ .00

Employment Desired:

Full Time Only
Part Time Only
  Full or Part Time

Days Available for work:

No Preference
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Available to work nights

Date available for work:

-- mm/dd/yy     Immediately

Education: Most recent first.

Name of School
Location
# of Years Completed
Major/Degree/Diploma

Name of School
Location
# of Years Completed
Major/Degree/Diploma

Name of School
Location
# of Years Completed
Major/Degree/Diploma

Experience:  Please list your work experience for the past five years beginning with your most recent job held. 

Employer
Address (Street/City/St/zip)
Name of Supervisor
Company or Supervisor Phone Number (ex: 555-555-5555)
Your Title
Emloyment Dates (mm/dd/year - mm/dd/year)
Duties performed, skills used/learned, advancements or promotions received
Pay or Salary (Start - Final)
Reason for leaving

Employer
Address (Street/City/St/zip)
Name of Supervisor
Company or Supervisor Phone Number (ex: 555-555-5555)
Your Title
Emloyment Dates (From mm/dd/year - mm/dd/year)
Duties performed, skills used/learned, advancements or promotions received
Pay or Salary (Start - Final)
Reason for leaving

Employer
Address (Street/City/St/zip)
Name of Supervisor
Company or Supervisor Phone Number (ex: 555-555-5555)
Your Title
Emloyment Dates (From mm/dd/year - mm/dd/year)
Duties performed, skills used/learned, advancements or promotions received
Pay or Salary (Start - Final)
Reason for leaving

May we contact your present employer?  Yes  No

Have you ever been convicted of a crime?  Yes No

If yes, please explain the number of conviction(s), nature of offense(s) leading to conviction(s), date(s) convicted, sentence(s) imposed and/or type(s) of rehabilitation.

Do you have a valid driver's license?  Yes No

References:  Please list two references other than relatives or previous employers.

Reference 1:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Reference 2:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone

Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying. 

This company is an equal employment opportunity employer.  We adhere to a policy of making employments decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability.  We assure you that your opportunity for employment with this company depends solely on your qualifications.