Tavern on France

952-358-6100

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Personal Information

Name *

Address *

City *

State *

Zip code *

Phone number *

Referred by

Are you 18 years of age or older? *
Yes No

If not 18, indicate age

Do you have legal right to work in US? *
Yes No

Employment Desired

Location *
Edina, MN Blaine, MN

Position *

Date you can start *

Wage desired *

Are you employed? *
Yes No

If so, may we contact your present employer? *
Yes No

Have you applied at the Tavern before? *
Yes No

If so, when?

Have you ever been convicted of a crime, Received Deferred Adjudication, pled no contest, or been placed on probation for a crime? *
Yes No

Education Background

	Name and Location of School	Years	Did You Graduate?	Subjects Studied
High School			Yes No
College			Yes No
Other			Yes No

Former Employers

List below last three employers, starting with the last one first.

Employment Dates

Name and Address of Employer

Salary/Wage

Position

Reason for Leaving

From:
To:

From:
To:

From:
To:

Availability

Please check each day by shift.

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Day (until 5pm)	Yes No	Yes No	Yes No	Yes No	Yes No	Yes No	Yes No
Night	Yes No	Yes No	Yes No	Yes No	Yes No	Yes No	Yes No

Do you live in this area year round? *
Yes No

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