bill bateman's bistro

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APPLICATION

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Personal Information

Location *		Date Available *
Position *		Date Available
2nd Choice		Last Name *
First Name *		Address 2
Address		State
City		Phone *
Zip		Birth Date
E-mail *		Social Security #

Are you still a student?
If Yes, Graduation Date:
Will you have reliable transportation to work?
Have you ever been convicted of a felony?
If yes, explain fully

Part Time Employees

Days & Hours Available

Work History

Begin with most resent - Include any present employment

Company #1

Company
Position
Reason For Leaving
Address
City
State
Supervisor's Name
Phone
Worked From (mm/yy)
Worked To (mm/yy)
Weekly or Hrly Pay

Company #2

Company
Position
Reason For Leaving
Address
City
State
Supervisor's Name
Phone
Worked From (mm/yy)
Worked To (mm/yy)
Weekly or Hrly Pay

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