First Name

Last Name

Cell Phone #

Email

Address

City

State

Start Date: Date you can start.

Are you an American Citizen? Are you an American Citizen? Yes No

Have you ever worked for at N'Orlins Cafe before? Have you ever worked for at N'Orlins Cafe before? Yes No

Have you ever been convicted of a felony? Have you ever been convicted of a felony? Yes No

Can you work nights and weekends? Can you work nights and weekends? Yes No

Employment History

Past Employer #1: Most Recent Employer Name

Past Employer's #1 Phone Number

Employment History #1: Please describe your most recent job and its responsibilities.

May we contact this employer? May we contact this employer? Yes No

Past Employer #2: Second Most Recent Employer Name

Past Employer's #2 Phone Number

Employment History #2: Please describe your second most recent job and its responsibilities.

May we contact this employer? May we contact this employer? Yes No

Past Employer #3: Third Most Recent Employer Name

Past Employer's #3 Phone Number

Employment History #3: Please describe your second most recent job and its responsibilities.

May we contact this employer? May we contact this employer? Yes No

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company for all liability for any damage that may result from utilization of such information. I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company for all liability for any damage that may result from utilization of such information. Agree