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Thank you for your interest in working for Iceberg Drive Inn. For 50 years, Iceberg has been - page 3 / 4

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EMPLOYMENT APPLICATION

NAME

_______________________________________________________

S O C I A L S E C U R I T Y # _ _ _ _ _ _ _ - _ _ _ _ _ _ - _ _ _ _ _ _ _

ADDRESS

________________________________

FIRST NAME

MIDDLE INITIAL

LAST NAME

CITY ______________________

STATE ZIP

______

____________

TELEPHONE #________________________

ARE YOU 18 OR OLDER? Y / N

IF NOT, GIVE BIRTHDATE

______________

HAVE YOU EVER WORKED AT AN ICEBERG DRIVE-INN? Y / N

IF YES, GIVE DATES

__________

TO

__________

GIVE ICEBERG LOCATION

____________________________________________

AVAILABILITY

TOTAL HOURS AVAILABLE PER WEEK

ARE YOU LEGALLY ABLE TO BE EMPLOYED IN THE U.S. ? Y / N

_______________

HOURS AVAIL. FROM TO

M

T

W

TH

F

SA

SU

HOW DID YOU HEAR ABOUT JOB?

HOW FAR DO YOU LIVE FROM RESTAURANT?

OWN TRANSPORTATION? Y / N

______________________

_________________

SCHOOL MOST RECENTLY ATTENDED

NAME OF SCHOOL ________________________

ADDRESS _____________________________

CITY __________________ STATE

__________

ZIP _______________

TEACHER/COUNSELOR

DEPARTMENT

LAST GRADE COMPLETED

GPA

__________________________

_______________________

_____________

______________

GRADUATED? Y / N

CURRENTLY ENROLLED? Y / N

THREE MOST RECENT JOBS

COMPANY

_________________________ ADDRESS

_____________________________

CITY

__________________

STATE

____________

ZIP

__________________

PHONE #

_________________ JOB DESCRIPTION

____________________________________________________

SUPERVISOR NAME

________________________

WAGE

DATES WORKED

TO

REASON FOR LEAVING

_____________

____________

____________

_______________________________________________________

COMPANY

_________________________ ADDRESS

_____________________________

CITY

__________________

STATE

____________

ZIP

__________________

PHONE #

_________________ JOB DESCRIPTION

____________________________________________________

SUPERVISOR NAME

________________________

WAGE

DATES WORKED

TO

REASON FOR LEAVING

_____________

____________

____________

_______________________________________________________

COMPANY

_________________________ ADDRESS

_____________________________

CITY

__________________

STATE

____________

ZIP

__________________

PHONE #

_________________ JOB DESCRIPTION

____________________________________________________

SUPERVISOR NAME

________________________

WAGE

DATES WORKED

TO

REASON FOR LEAVING

_____________

____________

____________

_______________________________________________________

IMPORTANT: COMPLETE OTHER SIDE OF APPLICATION

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