Personal Information
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First Name *
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Last Name *
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Current Address *
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City *
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State *
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Zip *
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Permanent Address
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City
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State
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Zip
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Current Phone Number *
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Permanent Phone Number
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Cell Phone Number *
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Email Address *
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How did you hear about job opportunities at BuffaLouies?
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Do you know anyone who is currently employed at BuffaLouies? *
YesNo |
If so, who?
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Have you ever been employed by BuffaLouie’s in the past? *
YesNo |
If so, dates of employment
(if hired, verification is required by law) |
Reason for leaving
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Are you legally eligible for work in the United States? *
YesNo
(if hired, verification is required by law) |
Have you been convicted of a crime in the last 7 years? *
YesNo |
If yes, please list convictions that are a matter of public record (an arrest is not a conviction). A conviction will not necessarily disqualify you from employment.
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Are you of legal age to serve alcohol? *
YesNo |
Do you have reliable means of transportation to work? *
YesNo |
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What position(s) are you applying for? *
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If applying for Delivery Driver, have you been involved in a moving vehicle violation
in the last 7 years? *
YesNo
(BuffaLouie’s will check the motor vehicle records of any job applicant, in every State of previous employment, when driving is an essential job function) |
If yes, please list
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What skills do you have that are applicable to position(s) applied for? *
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Date available for employment
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Date available for employment *
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If hired, how long do you plan to be employed by BuffaLouie’s? *
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How many hours are you able to work per week? *
(BuffaLouie’s is open for business 7 days a week) |
Do you have any regularly scheduled or intermittent obligations that may affect your
availability to work? *
YesNo |
If yes, please list
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Specify hours available each day of the week |
Monday |
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Tuesday |
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Wednesday |
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Thursday |
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Friday |
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Saturday |
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Sunday |
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Education
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High school |
Name and Address of School
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Last year completed
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Did you Graduate?
YesNo |
Subjects studied, Degrees received
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College |
Name and Address of School
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Last year completed
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Did you Graduate?
YesNo |
Subjects studied, Degrees received
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Post College |
Name and Address of School
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Last year completed
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Did you Graduate?
YesNo |
Subjects studied, Degrees received
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Trade, business or correspondence school |
Name and Address of School
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Last year completed
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Did you Graduate?
YesNo |
Subjects studied, Degrees received
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Employment History
Provide information for your last 3 employers starting with the most recent. If never employed, list any volunteer activities. |
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Employer1
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Supervisor
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Position held
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Dates (From: to)
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Location
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Phone Number
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Last rate of pay
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Reason for leaving
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Are you eligible for rehire?
YesNo
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Employer2
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Supervisor
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Position held
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Dates (From: to)
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Location
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Phone Number
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Last rate of pay
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Reason for leaving
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Are you eligible for rehire?
YesNo
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Employer3
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Supervisor
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Position held
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Dates (From: to)
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Location
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Phone Number
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Last rate of pay
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Reason for leaving
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Are you eligible for rehire?
YesNo
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Personal References
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Name
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Phone Number
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Occupation
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Relationship
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Years acquainted
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Name
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Phone Number
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Occupation
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Relationship
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Years acquainted
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Name
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Phone Number
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Occupation
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Relationship
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Years acquainted
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