Personal Information
Name: First, Middle:		,
Last:
Email Address :
Date of Birth: (Optional)
Present Address: (Street, City, State, Zip)
Home Phone #:
Social Sec. No.:
What date can you start:
Case of emergency, notify: (Name, Relationship, Address, Phone)
Referral Source:		Friend Relative Website Ad Other (Explain)
Have you ever applied for a job with this company before?		Yes   No If Yes...When?
Number of hours per wk desired:
Position Desired:		1st choice  2nd choice
Pay Desired:		$
List any hours you are NOT available to work:

Health and Safety
Have you ever been convicted of a crime?		No Yes   (Explain)
Have you used any names or social security numbers other than those listed above?		No Yes
Are you authorized to work in the U.S. on a restricted basis?		No Yes
List the states resided for the past seven years:

Education

School Level School Name Location Major No. Years Attended Date of Graduation High School College

Experience   List Your Last Four Employers, starting with Present or Most Recent

Employer Address- Location Phone # Position From: Mo/Yr To: Mo/Yr Reason For Leaving

Job Related Skills
Do you have a valid driver's license?		No Yes   State Issued: SelectALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWI    Driver's License #
Type of Driver's License:		(Restriction:)
Please list any other job-related skills or experience:

References   (Include only individuals familiar with your work ability; do not    include relatives)

Name Phone Name of Business/Address Years Acquainted Relationship

Authorization

I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the company and/or its agents, including consumer reporting bureaus, to investigate my background and all statements contained in the application, as may be necessary in arriving at any employment decision (including, but not limited to, criminal history, motor vehicle driving records and credit history). I release Gables Nightclub and/or its agents from any liability which might arise from such an investigation. (By checking this box, I agree to the above as if I had signed my initials) I understand that this application is not a contract of employment. In the event of employment, I understand that false or misleading information given in my application or interview(s) will result in termination. I understand that in the event of employment my employment relationship is terminable at will and is not governed by an employment contract. I also understand that the use of illegal drugs or alcohol is prohibited during employment and is grounds for immediate termination. In the event that I am employed, I agree to abide by all Gables Nightclub policies and standards. I also understand and agree that a drug test may be administered prior to or at any time during my employment.  (By checking this box,  I agree to the above as if I had signed my initials) PLEASE NOTE: The above 2 boxes must be checked & you must also type your name & date in the Signature boxes below to validate this application & be considered for employment. Signature:        Date: (By placing my name here, I agree to the above as if I had given my signature.)