JOIN THE TEAM - The GasLite

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Name and Position - Step 1 of 7

First Name *

Last Name *

Application Date *

Position Applied For *

Other Position Explanation

How did you hear about us or the position? *

Which employee informed you of the position?

Are you at least 21 years old? *

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WORK AVAILABILITY

Available Start Date *

Start Date Explanations, if any

I am available for all 6 AM to 11 AM morning shifts: *

Yes
No
Maybe

I am available for the following 6 AM to 11 AM morning shifts: *

Sunday morning
Monday morning
Tuesday morning
Wednesday morning
Thursday morning
Friday morning
Saturday morning
No morning

Maybe morning shifts explanation *

I am available for all 11 AM to 4 PM day shifts: *

Yes
No
Maybe

I am available for the following 11 AM to 4 PM shifts: *

Sunday afternoon
Monday afternoon
Tuesday afternoon
Wednesday afternoon
Thursday afternoon
Friday afternoon
Saturday afternoon
No afternoon

Maybe day shifts explanation *

I am available for all 4 PM to 9 PM happy hour shifts: *

Yes
No
Maybe

I am available for the following 4 PM to 9 PM happy hour shifts: *

Sunday afternoon
Monday afternoon
Tuesday afternoon
Wednesday afternoon
Thursday afternoon
Friday afternoon
Saturday afternoon
No afternoon

Maybe happy hour shifts explanation *

I am available for all 9 PM to 2 AM night shifts: *

Yes
No
Maybe

I am available for the following 9 PM to 2 AM night shifts: *

Sunday night
Monday night
Tuesday night
Wednesday night
Thursday night
Friday night
Saturday night
No night

Maybe 9 PM to 2 AM nights explanation: *

Explanation, if any, regarding availability

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CONTACT INFORMATION

Applicant Phone *

Applicant Other Phone

Applicant Email *

Applicant Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Applicant Permanent Address (if different)

Address Line 1

Address Line 2

City

State

Zip Code

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PAST EMPLOYMENT

Most Recent Employer

Name of Employer #1 (most recent) *

Position(s) Held (Employer #1) *

Start Date (Employer #1) *

Are you still working for this employer (Employer #1)? *

Do you plan to continue working for this employer (Employer #1)? *

Yes
No
Maybe

End Date (Employer #1) *

Reason for Leaving (Employer #1) *

Street Address (Employer #1) *

City (Employer #1) *

State (Employer #1) *

Zip Code (Employer #1) *

Phone (Employer #1) *

Explanation, if any (regarding Employer #1)

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Second Most Recent Employer

Name of Employer #2 (second most recent)

Position(s) Held (Employer #2)

Start Date (Employer #2)

Are you still working for this employer (Employer #2)?

Do you plan to continue working for this employer (Employer #2)?

Yes
No
Maybe

End Date (Employer #2) *

Reason for Leaving (Employer #2) *

Street Address (Employer #2)

City (Employer #2)

State (Employer #2)

Zip Code (Employer #2)

Phone (Employer #2)

Explanation, if any (Employer #2)

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Third Most Recent Employer

Name Employer #3 (third most recent)

Position(s) Held (Employer #3)

Start Date (Employer #3)

Are you still working for this employer (Employer 3)?

Do you plan to continue working for this employer (Employer #3)?

Yes
No
Maybe

End Date (Employer #3) *

Reason for Leaving (Employer #3) *

Street Address (Employer #3)

City (Employer #3)

State (Employer #3)

Zip Code (Employer #3)

Phone (Employer #3)

Explanation, if any (Employer #3)

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EDUCATION

Last High School Attended *

City (Last High School) *

State (Last High School)

Did you graduate high school? *

Last College/University Attended

City (Last College/Univ)

State (Last College/Univ)

Did you graduate Last College?

Major Area of Study

Degree Achieved (Last College)

Explanation, if any, regarding education

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REFERENCES

Name (Reference #1) *

Phone (Reference #1) *

Email (Reference #1) *

Years Known (Reference #1) *

Name (Reference #2)

Phone (Reference #2)

Email (Reference #2)

Years Known (Reference #2)

Name (Reference #3)

Phone (Reference #3)

Email (Reference #3)

Years Known (Reference #3)

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CERTIFICATION

I certify that the above answers are correct to the best of my knowledge. I understand that a background check may be performed if the company plans to hire me.

Signature *

Clear Signature

Date / Time of Signature *

Date

Time

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Starts Mon-Thurs at 8 PM,
Fri-Sun at 6 PM

Book a Party!

Make a reservation!
Book a private party!

Get More Info!

Find our address, hours, directions,
and contact info.

Entertainment!

World-famous karaoke.
Starts Mon-Thurs at 8 PM,
Fri-Sun at 6 PM

Book a Party!

Make a reservation!
Book a private party!

Get More Info!

Find our address, hours, directions,
and contact info.