Application for Employment

Our policy is to provide equal opportunity to all qualified persons without regard to race, creed, religious belief, sex, age, national origin, ancestry, physical disability, mental disability or veteran status.

Today's Date

First Name *

Last Name *

Middle Name *

Address *

City *

State *

Postal code *

Phone *

Are You Legally Permitted To Work In The United States? *

Yes

Have You Ever Been Convicted Of A Felony? (If Yes Please List Date And Description, If No Put Down N/A) *

How Did You Hear About This Postion? *

Have You Ever Been Employed By Society Lounge? *

If Employed Prior When & What Position?

Are You Currently Employed? *

May We Contact Your Current Employer? *

Do You Have Any Restrictions On Availability? *

High School Name *

High School Location *

Did You Graduate? *

High School Notable Extra-Curricular Activities Or Awards?

College Name *

College Location *

Did You Graduate College? *

College Notable Extra-Curricular Activities Or Awards *

Are Your Planning On Continuing Your Studies? *

If Yes, Where & What Course Of Studies?

Other Notable Education, Experience, Training, Or Certifications?

Most Recent Work Experience

Most Recent Company Name *

Location (most recent) *

Best Contact (most recent) *

Best Contact Phone (most recent) *

Date Started (most recent) *

Ending Wage (most recent) *

Position (most recent) *

Notes (most recent) *

Prior Work Experience

Company Name (prior employment)

Location (prior employment)

Date Started (prior employment)

Date Ended (prior employment)

Position (prior employment)

Any Notable Prior Work Experience

Please List 3 Professional References

Reference 1: Full Name *

Reference 1: City of Residence *

Reference 1: Phone *

Reference 1: Year Known *

Reference 1: Relation *

Reference 1: Why Did You Choose This Person? *

Reference 2: Full Name *

Reference 2: City of Residence *

Reference 2: Phone *

Reference 2: Years Known *

Reference 2: Relation *

Reference 2: Why Did You Choose This Person? *

Reference 3: Full Name *

Reference 3: City of Residence *

Reference 3: Phone *

Reference 3: Years Known *

Reference 3: Relation *

Reference 3: Why Did You Choose This Person? *

Open Availability? *

If No, What Days & Times Are You Not Available?

Emergency Contact Info

Emergency Contact: Full Name *

Emergency Contact: Phone *

Emergency Contact: Full Address *

Please Read Before Signing:

I certify that all information provided by me on this application is true and complete to the best of my knowledge and that I have withheld nothing that, if disclosed, would alter the integrity of this application.

I authorize my previous employers, schools, or persons listed as references to give any information regarding employment or educational record. I agree that this company and my precious employers will not be held liable in any respect if a job offer is not extended, or is withdrawn, or employment is terminated because of false statements, omissions, or answers made by myself on this application. In the event of any employment with this company, I will comply with all rules and regulations as set by the company in any communication distributed to the employees.

In compliance with the Immigration Reform and Control Act of 1986, I understand that I am required to provide approved documentation to the company that verifies my right to work in the United States on the first day of employment. I have received from the company a list of approved documents that are required.

I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I hereby acknowledge that I have read and understand the above statements.

Application Signature *

Clear