CCR Application for Employment

Job Application

Please fill out the application as thoroughly as possible. Items with a * are required.

Date Field Note: The best way to enter a date is to click on the small calendar icon next to a date field.
If you want to enter dates manually, use 2 digit month, 2 digit day, and 4 digit year. If you only remember the month and year, simply enter the date as "01" (for example, March of 2007 would be entered as "03/01/2007" )

Full Name *
Name you prefer to be called (or Nickname)
Street Address
City
State
Zip Code
Home Phone	- -
Mobile Phone	- -
Email
Are you either a U.S. citizen or an alien authorized to work in the U.S.? *	Yes No
Are you at least 16 years of age or over? (note: at this time Carriage Crossing is not hiring anyone under the age of 16.) *	Yes No
What is the PRIMARY position for which you are applying? *	Server Host Line Cook Prep Cook Dishwasher Pie/Bread Baker Gift Shop Management
What is your SECOND choice of positions?	Server Host Line Cook Prep Cook Dishwasher Pie/Bread Baker Gift Shop NO SECOND CHOICE
Date you can start work. *
Salary / Wage Desired *
Are you employed now? *	Yes No
If so, may we contact your present employer?	Yes No
Have you worked for Carriage Crossing or Dutch Kitchen before? *	Yes No
If so, when?
----- EDUCATION INFORMATION -----
Name and location of high school
Years Attended
Did you graduate?	Yes No
Subjects Studied
Name and location of college / university
Years Attended
Did you graduate?	Yes No
Subjects studied
Name and location of business or trade school
Years Attended
Did you graduate?	Yes No
Subjects Studied
----- EMPLOYMENT HISTORY -----
List below your last three employers, starting with the most recent first.
Employer 1 Name and Location
Start Date:
End Date:
Rate of Pay
Position / Duties
Reason for Leaving
Employer 2 name and location
Start Date:
End Date:
Rate of Pay
Position / Duties
Reason for leaving
Employer 3 name and location
Start Date:
End Date:
Rate of pay
Position / Duties
Reason for leaving
U.S. Military Service, Dates, Rank
----- REFERENCES -----
Give the names of three persons not related to you, whom you have know for at least one year.
Reference 1 Name
Contact Info
Business
Years Acquainted
Reference 2 Name
Contact Info
Business
Years Acquainted
Reference 3 Name
Contact Info
Business
Years Acquainted
----- AVAILABILITY -----
Carriage Crossing employees work on a set schedule. Your schedule will be based on the information you supply here.
MON Breakfast & Lunch *	Yes No
TUES Breakfast & Lunch *	Yes No
WED Breakfast & Lunch *	Yes No
THURS Breakfast & Lunch *	Yes No
FRI Breakfast & Lunch *	Yes No
SAT Breakfast & Lunch *	Yes No
MON Dinner *	Yes No
TUES Dinner *	Yes No
WED Dinner *	Yes No
THURSDAY Dinner *	Yes No
FRI Dinner *	Yes No
SAT Dinner *	Yes No
ABOUT YOURSELF: What sports, activities, hobbies do you enjoy?
I have read and agreed to the statements below regarding truth in application, investigation of my statements and period of employment. *	Yes No

Please type the code shown in the image: *

Truth in Application Statement:

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 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 all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.