(772) 872-7250
625 SW Anchorage Way Stuart, FL 34994
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Employment
Employment Application
Please complete form below and we will get back to you. Thank you!
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Date
Name
*
First
Last
Current Address:
How Long?
Year(s)/Month(s)
Phone:
Expected Hourly Wage:
Reliable Transportation:
Yes
No
Position applying for?
Full/Part
Full-Time
Part-Time
How many hours can you work per week?
Do you have legal documentation to work?
Yes
No
Are you legal age to serve alcohol?
Yes
No
Have you been convicted of a felony within the past 15 years that has not been expunged?
Yes
No
Can you work flexible hours including weekends?
Yes
No
Are you willing to work holidays?
Yes
No
What commitments do you have or anticipate that may affect your schedule?
Please check all shifts that you are regularly available for A.M.
Mon
Tues
Weds
Thurs
Fri
Sat
Sun
Please check all shifts that you are regularly available for P.M.
Mon
Tues
Weds
Thurs
Fri
Sat
Sun
If hired, what notice do you need to give your current employer?
When are you available to start?
Why are you applying a position with us?
NAME OF EMPLOYER (Previous Employer)
PLEASE COMPLETE WORK HISTORY BELOW. DO NOT WRITE "SEE RESUME".
LOCATION (Most Recent)
PLEASE COMPLETE WORK HISTORY BELOW. DO NOT WRITE "SEE RESUME".
LOCATION (Previous Employer)
PLEASE COMPLETE WORK HISTORY BELOW. DO NOT WRITE "SEE RESUME".
MAY WE CONTACT EMPLOYER?
Yes
No
SUPERVISOR'S NAME & NUMBER (Most Recent)
PLEASE COMPLETE WORK HISTORY BELOW. DO NOT WRITE "SEE RESUME".
SUPERVISOR'S NAME & NUMBER (Previous Employer)
PLEASE COMPLETE WORK HISTORY BELOW. DO NOT WRITE "SEE RESUME".
LENGTH OF EMPLOYMENT & POSITION HELD (Most Recent)
LENGTH OF EMPLOYMENT & POSITION HELD (Previous Employer)
DESCRIPTIONS OF DUTIES (Most Recent)
DESCRIPTIONS OF DUTIES (Previous Employer)
HOURLY PAY RATE (Most Recent)
HOURLY PAY RATE (Previous Employer)
AVERAGE NUMBER OF HOURS WEEKLY (Most Recent)
AVERAGE NUMBER OF HOURS WEEKLY (Previous Employer)
REASON FOR LEAVING (Most Recent)
REASON FOR LEAVING (Previous Employer)
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