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Chiles & Peppers
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Employment
Name (Required)
Name (Required)
Phone
Phone
Email (Required)
Email (Required)
Street
Street
City
City
State/Province
State/Province
Zip/Postal Code
Zip/Postal Code
What position are you applying for? (Required)
Waiter/Waitress
Host/Hostess
Bartender
Management
Cooking
Cashier
Busboy
Dishwasher
Date Available to Start:
Date Available to Start:
School:
School:
What is your salary requirement (if any)?
What is your salary requirement (if any)?
Number of hours desired:
Number of hours desired:
Years Attended
Years Attended
Graduated?
Yes
No
Are there any days you are not available?
Are there any days you are not available?
Physical Restrictions (i.e. Heavy Lifting):
Physical Restrictions (i.e. Heavy Lifting):
Company Name:
Company Name:
Position(s) Held:
Position(s) Held:
Do you have your own transportation?
Yes
No
Upload Your Resume: (Required) (pdf, doc, docx):
Date of Employment
Date of Employment
Phone:
Phone:
Supervisor:
Supervisor:
Title:
Title:
Responsibilities:
Responsibilities:
Starting Pay Rate and Position:
Starting Pay Rate and Position:
Ending Salary and Title:
Ending Salary and Title:
Reason for Leaving:
Reason for Leaving:
May we contact this employer for a reference?
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No
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