Prairie House Restaurant

EMPLOYMENT APPLICATION

All applicants will receive consideration without discrimination based on sex, marital status, race, color, age, creed, national origin, sexual orientation, military reserve membership, ancestry, religion, height, weight, use of a guide or support animal because of blindness, deafness or physical handicap or the presence of disabilities.

This application for employment opportunities may take 10 to 15 minutes to complete. Good luck!!


PERSONAL INFORMATION

Last Name *
First Name *
Birthdate *

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DD
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Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Phone *

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Email *
Have you ever been convicted of a crime? *
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s).

AVAILABILITY

Check all that apply
Position Applied For *
Employment Desired *
Date Available to Start *

MM
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DD
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Do you have reliable transportation? *
SUNDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 
MONDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 
TUESDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 
WEDNESDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 
THURSDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 
FRIDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 
SATURDAY *
 Breakfast  
 Lunch  
 Dinner  
 Not Available 

EDUCATION

High School
Location
Completion Year
College/ Trade School
Location
Completion Year

EMPLOYMENT HISTORY

Employer
City, State
Phone

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May we contact?
Start Date

MM
/
DD
/
YYYY
End Date

MM
/
DD
/
YYYY
Duties/ Responsibilities
Employer
City, State
Phone

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-
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-
####
May we contact?
Start Date

MM
/
DD
/
YYYY
End Date

MM
/
DD
/
YYYY
Duties/ Responsibilities

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