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Employment Application

    Personal Information
    First Name *
    		 Last Name *
    Current Address *
    City *
    		 State *
    		 Zip *
    Permanent Address
    City
    		 State
    		 Zip
    Current Phone Number *
    		 Permanent Phone Number
    Cell Phone Number *
    		 Email Address *
     
    How did you hear about job opportunities at BuffaLouies?
    Do you know anyone who is currently employed at BuffaLouies? *
    YesNo
    If so, who?
    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
    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.
    Are you of legal age to serve alcohol? *
    YesNo
    Do you have reliable means of transportation to work? *
    YesNo
     
    What position(s) are you applying for? *
    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
    What skills do you have that are applicable to position(s) applied for? *
     
    Date available for employment
    Date available for employment *
    If hired, how long do you plan to be employed by BuffaLouie’s? *
    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
    Specify hours available each day of the week
    Monday
    Tuesday
    Wednesday
    Thursday
    Friday
    Saturday
    Sunday

    Education
    High school
    Name and Address of School
    Last year completed
    		 Did you Graduate?
    YesNo
    Subjects studied, Degrees received
     
    College
    Name and Address of School
    Last year completed
    		 Did you Graduate?
    YesNo
    Subjects studied, Degrees received
     
    Post College
    Name and Address of School
    Last year completed
    		 Did you Graduate?
    YesNo
    Subjects studied, Degrees received
     
    Trade, business or correspondence school
    Name and Address of School
    Last year completed
    		 Did you Graduate?
    YesNo
    Subjects studied, Degrees received

    Employment History

    Provide information for your last 3 employers starting with the most recent. If never employed, list any volunteer activities.
     
    Employer1
    		 Supervisor
    Position held
    		 Dates (From: to)
    Location
    		 Phone Number
    Last rate of pay
    		 Reason for leaving
    Are you eligible for rehire?
    YesNo
     
    Employer2
    		 Supervisor
    Position held
    		 Dates (From: to)
    Location
    		 Phone Number
    Last rate of pay
    		 Reason for leaving
    Are you eligible for rehire?
    YesNo
     
    Employer3
    		 Supervisor
    Position held
    		 Dates (From: to)
    Location
    		 Phone Number
    Last rate of pay
    		 Reason for leaving
    Are you eligible for rehire?
    YesNo

    Personal References
    Name
    Phone Number
    		 Occupation
    Relationship
    		 Years acquainted
     
    Name
    Phone Number
    		 Occupation
    Relationship
    		 Years acquainted
     
    Name
    Phone Number
    		 Occupation
    Relationship
    		 Years acquainted