ADDRESS Address 1 Address 2

PHONE EMAIL ADDRESS

If hired, do you have a reliable means of transportation to get to work? * YesNo

Are you at least 18 years of age? * YesNo

Are you legally eligible for employment in the U.S.? *(Proof of U.S. citizenship or immigration status is required if hired.) YesNo

EMPLOYMENT DESIREDHostess / Waitress / Waiter / Server / Cook / Chef / Management DATE YOU CAN START

Are you currently employed? * YesNo

SCHEDULE AVAILABILITY *Please mark the days you would like to work. MondayTuesdayWednesdayThursdayFridaySaturdaySunday

SALARY DESIRED *Per hour WHICH LOCATION YOU WOULD LIKE TO APPLY FOR? *Choose location Boca RatonDania BeachFort LauderdaleHallandale BeachPlantation

ARE YOU SEEKING *Choose one or morePart timeFull timeTemporary employment

ARE YOU WILLING TO WORK OVERTIME? *Choose one or moreYesNoWeekendsHolidays

EMPLOYER NAME EMPLOYER ADDRESS Address 1 Address 2

SALARY Per hour POSITION REASON FOR LEAVING

SCHOOL* Please choose the highest level of education achieved High School/GEDBachelor'sMastersSCHOOL NAME*

DEGREE* Describe if received a degree/diploma YesNo

YEARS COMPLETED*

OTHER SCHOOL Please choose the highest level of education achieved High School/GEDBachelor'sMastersSCHOOL NAME

DEGREE* Describe if received a degree/diploma YesNo

YEARS COMPLETED

PHONE

EMAIL ADDRESS