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Address

Name: *

Dates of Employment

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Dates of Employment

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Highest Education Completed (select one):

Supervisor

Work History 1

Would you accept another position?

Yes

No

Other

Are you willing to work: (check all that apply)

Over 40 Hours

Irregular Shifts

Nights

Weekends

Referred By

Are you currently Attending School?

Yes

No

Available Start Date *

Emergency Contact Information

Pay Rate

Phone *

Employment Type *

Full Time

Part Time

Reason for Leaving

Supervisor

Application for Employment - The Log Cabin Restaurant

Pay Rate

Work History 3

Are you legally eligible for employment in the U.S.?

Yes

No

Job Title

Phone Number

Expected Wage/Salary

Highschool

Type of work preferred

Reason for Leaving

Supervisor

Work History 2

If yes: when and reason for leaving:

Phone Number

Reason for Leaving

Job Title

Total Hours Available per Week

Dates of Employment

To

Phone Number

Have you ever worked for this company before?

Yes

No

Pay Rate

College

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11 Lehoy Forest Drive Leola PA 17540

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