APPLICANT INFORMATION

DESIRED EMPLOYMENT/LOCATION

CHOOSE DESIRED LOCATIONGREENBRIERLYNNHAVENNORTHAMPTON

WHAT IS YOUR AVAILABILITY?

ARE YOU AVAILABLE TO WORK ON WEEKENDS?
YESNO

DO YOU HAVE YOUR OWN FORM OF TRANSPORTATION?
YESNO

ARE YOU A CITIZEN OF THE UNITED STATES?
YESNO

IF NO, ARE YOU AUTHORIZED TO WORK IN THE U.S.?
YESNO

HAVE YOU EVER WORKED FOR POP'S DINER CO.?
IF YES, DATES EMPLOYED:

HAVE YOU EVER BEEN CONVICTED OF A FELONY?
YESNO

PREVIOUS EMPLOYMENT

PREVIOUS EMPLOYER 1

RESPONSIBILITIES:

MAY WE CONTACT YOUR PREVIOUS SUPERVISOR FOR REFERENCE?
YESNO

PREVIOUS EMPLOYER 2

RESPONSIBILITIES:

MAY WE CONTACT YOUR PREVIOUS SUPERVISOR FOR REFERENCE?
YESNO

PREVIOUS EMPLOYER 3

RESPONSIBILITIES:

MAY WE CONTACT YOUR PREVIOUS SUPERVISOR FOR REFERENCE?
YESNO

DISCLAIMER AND AUTHORIZATION
I Certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information on my application or interview may result in my release.
Disclaimer Authorization