It is the policy of Swezey's Pub to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, gender, national origin, age, disability or veteran status.
Number of years at this address:
* Email Address:
Social Security Number:
Drivers License Number:
Who should we contact in case of emergency?:
Relationship to you:
Contact Day Phone:
Contact Evening Phone:
Job Position Applied For
Are you 18 or over?:
Are you willing to work any shift, including nights and weekends?
If no, please state any limitations:
If applicable, are you available to work overtime?
If hired, when can you start?:
If hired, are you able to submit proof that you are legally eligible for employment in the United States?
Are you able to perform the essential functions of the job position you seek with or without reasonable accommodation?
Able to Perform:
What accommodation, if any?:
Convictions: Have you ever been convicted of a felony or misdemeanor?
If Yes, please explain
I was convicted of:
On the following date:
In City, State:
THE EXISTENCE OF A CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT UNLESS RELEVANT TO THE TYPE OF EMPLOYMENT.
List any skills that may be useful for the job you are seeking. Enter the number of years of
experience, and your ability for each particular skill. (One represents poor ability, while five represents exceptional ability.)
Skill 1 years:
Skill 1 Ability:
Skill 2 Years:
Skill 2 Ability:
Applicant Employment History: List your current or most recent employment first. Please list all jobs (including self-employment and military service) which you have held, beginning with the most recent, and list and explain any gaps in employment. If additional space is needed, continue on the back page of this application.
Employer 1 Name:
Supervisor 1 Name:
Employer 1 Address:
Job 1 Duties:
Reason for leaving Job 1:
Job 1 Dates of Employment (From/To):
Employer 2 Name:
Supervisor 2 Name:
Employer 2 Address:
Job 2 Duties:
Reason for leaving Job 2:
Job 2 Dates of Employment (From/To):
Employer 3 Name:
Supervisor 3 Name:
Employer 3 Address:
Job 3 Duties:
Reason for leaving Job 3:
Job 3 Dates of Employment (From/To):
Educational Background: Please provide YEARS COMPLETED, DID YOU GRADUATE, COURSE OF STUDY
Awards, Honors, Achievements:
References: List any two non-relatives who would be willing to provide a reference for you.
Ref 1 Name:
Ref 1 Address:
Ref 1 Phone:
Ref 1 Relationship:
Ref 2 Name:
Ref 2 Address:
Ref 2 Phone:
Ref 2 Relationship:
Please provide any other information that you believe should be considered, including
whether you are bound by any agreement with any current employer.
* 1 + 5 =
Enter the correct answer to the math question.
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