EMPLOYMENT APPLICATION   Programs, services, and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accommodation for this application or interview. APPLICATION DATA How were you referred to us: Full name: Address City State Pennsylvania 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 Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code   Phone Mobile/Pager/Other E-Mail Date Available to Start Salary Requirements If you are under 18 years of age, can you provide a work permit. YES NO Have you ever worked for this company? YES NO if yes, when? Are you legally allowed to work in the United States? YES NO   Type of Employment Desired Please Choose Full-Time Part-Time Temporary Seasonal Days Evenings Weekdays Weekends OPEN Position Applying For Please Choose Host Buser Server Banquet Dish Washer Prep Line Cook Other Have you ever pleaded guilty, no contest or been convicted of a crime?YES NO Answering yes to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered. Summarize Your Special Skills or Qualifications