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Personal

*Today'sDate:
*Full Name:
*Street Address:
*City:
*State:
*Zip:
*Home Phone:
( ) -
*Cell Phone:
( ) -
*E-mail Address
Are you 16 years of age or older?
Are you 18 years of age or older?
Are you 21 years of age or older?
Have you ever been employed by Levy Restaurants in the past?
If yes, dates of employment:
Position:

Education

 
*Select Highest Level Completed:
High School
College

Skills

*Skills (Include any skills specific to the food industry, and any general skills such as computer proficiency or languages spoken):
Licenses or certificates:

Employment History

List current or previous employers

*Employer #1:
*From:
*To:
Today
*Job Title:
*Supervisor Name:
Reason for Leaving:
Employer #2:
From:
To:
Today
Job Title:
Supervisor Name:
Reason for Leaving:
*May we contact current/previous employers?

General

*Do you have a legal right to work in the United States?
*Have you ever been convicted of a felony?
If yes, please explain and give city, state and date(s):
*I certify that the information on this application and any attachments are accurate and complete. I have not willingly withheld information and I understand that incomplete and inaccurate or false information will result in rejection or my application or termination of employment. Due to the nature of the business, it may be as many as 90 days after submitting your application before you are contacted.

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