Application for Employment Pre-Employment QuestionnaireEqual Opportunity Employer Personal InformationName* First Middle Last Present Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Permanent Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Referred ByEmployment DesiredAre you 18 years or older?*YesNoPosition*Select a PositionAM Prep StaffBartenderBusserCustodianDelivery DriverDishwasherExpeditorHostLine CookPhone BuddyPizza CookSalad/Sandwich PrepServerDate you can start*Are you currently authorized to work in the US for any employer?*YesNoAre you looking for seasonal employment only?*YesNoAre you currently employed?*YesNoMay we inquire of your present employer?YesNoPlease check if you have worked at any of these: Moosejaw Buffalo Phil's Kickers When did you work at Moosejaw?When did you work at Buffalo Phil's?When did you work at Kickers?Please check if you have applied at any of these: Moosejaw Buffalo Phil's Kickers When did you apply at Moosejaw?When did you apply at Buffalo Phil's?When did you apply at Kickers?Education HistoryHigh SchoolName & Location of School*Subjects Studied*Did you graduate?*YesNoCollege/Trade SchoolName & Location of SchoolSubjects StudiedDid you graduate?YesNoName & Location of SchoolSubjects StudiedDid you graduate?YesNoGeneral InformationSubjects of special study/research work, or special skillsUS Military or Naval ServiceRankFormer EmployersEmployer 1Name & Address*Dates Worked*Salary*Position*Reason for Leaving*Employer 2Name & AddressDates WorkedSalaryPositionReason for LeavingEmployer 3Name & AddressDates WorkedSalaryPositionReason for Leaving