Premier Speakeasy Employment Application

Date Available (required)

Type of employment desired (required)
Full Time
Part Time

Are you legally allowed to work in the U.S.? (required)
Yes
No

If you are under 18 years of age, can you provide a work permit?
Yes
No

If no, please explain

Have you ever worked for this company? (required)
Yes
No

If yes, when?

Answering yes to the following question does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for, will be considered.

Have you ever pleaded guilty, no contest or been convicted of a crime? (required)
Yes
No

If yes, please give dates and details

Please summarize your special skills or qualifications

- PREVIOUS EMPLOYMENT -

Employment Dates

Position Held

Company Name

City

State

Zip Code

Phone

Supervisor

Title

Starting Title

Ending Title

Job Responsibilities

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview may be reason for discharge.

I accept these terms (required)
Yes

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