First Name:

Last Name:

Address:

City:

State:

Zip:

Email:

Home Phone:

Cell Phone:

Referred By:

Have you been previously employed with this company?

Yes No

Position Desired:

High School:

Grade Level:

College:

Level:

Major:

US Citizen:

YesNo
(If no, have you legal
right to remain in the U.S.?)
YesNo

Have you ever been convicted of any crime(s) other than minor traffic violations?:

YesNo

If yes, please explain when, where and disposition of the case(s):

Previous Employment:

Dates:

From:To:

Name of Employer:

Address:

City:

State:

Zip:

Phone:

Position:

Reason for leaving:

When are you available to begin work:

Check one:

Full TimePart Time

Will you have any other daytime employment:

YesNo

Briefly explain why you are interested in working for Behle Street Cafe and state any qualifications you have that might possibly assist you in your employment.

By submitting this application, I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for, is cause for dismissal. Further, I understand and agree that my employment is for no definite period, and may be terminated at any time without any previous notice.

This form can either be submitted to Behle Street Cafe by clicking the submit button or it may be printed and mailed to: