Online Job Application

Date
Month
Day
Year
APPLICANT INFORMATION
First Name
M.I.
Last Name
Address
Street Address Address Line 2 City State ZIP Code
Phone
Email
Days of week not available for work
Times of year not available for work
EDUCATION
High School
Address
Attended from
to
Did you graduate?
- Yes
- No
Additional Education Information
REFERENCES
Please list a personal references.
Full Name
Relationship
Phone
Address
CURRENT/MOST RECENT WORK
Company
Phone
Address
Supervisor
Job Title
Responsibilities
From
to
Reason for Leaving
May we contact your previous supervisor for a reference?
- Yes
- No
OTHER INFORMATION
Please answer all questions.
Please describe what you feel is special about the Delta Diner.
Describe a past experience where you considered going to work fun, and why?
Is the Customer Always Right?
Disclosure and Signature
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Full Name

Please type your full name above to electronically sign this application.
Comments
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APPLICANT INFORMATION