Add Your Heading Text Here Join The GasLite TeamPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name and Position - Step 1 of 7First Name *Last Name *Application Date *Position Applied For *PositionBartenderCocktail ServerDoor HostKaraoke HostOffice/AdministrationOtherAre you available for a quick interview this Saturday, April 6th? *YesNoAre you available for a quick interview on Wednesday, April 3rd? *YesNoPlease choose an interview time: *11:15 AM11:30 AM11:45 AM12:00 Noon12:15 PM1:00 PM1:15 PM1:30 PM1::45 PM2:00 PM2:15 PM2:30 PM2:45 PMPlease choose a time for your interview: *10:45 AM11:00 AM11:15 AM11:30 AM11:45 AM12:00 Noon12:15 PM1:00 PM1:15 PM1:30 PM1::45 PM2:00 PM2:15 PM2:30 PM2:45 PMPlease tell us when you will be available for an interview. *Other Position ExplanationHow did you hear about us or the position? *How I learned of positionI saw an adI know someone who works hereI am a customerI heard about it from a friendI just decided to askOtherWhich employee informed you of the position?Are you at least 21 years old? *At least 21?YesNo♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎NextWORK AVAILABILITYAvailable Start Date *Start Date Explanations, if anyI am available for all morning shifts: *YesNoMaybeI am available for the following morning shifts: *Sunday morningMonday morningTuesday morningWednesday morningThursday morningFriday morningSaturday morningMaybe mornings explanation *I am available for all afternoon shifts: *YesNoMaybeI am available for the following afternoon shifts: *Sunday afternoonMonday afternoonTuesday afternoonWednesday afternoonThursday afternoonFriday afternoonSaturday afternoonMaybe afternoons explanation *I am available for all night shifts: *YesNoMaybeI am available for the following night shifts: *Sunday nightMonday nightTuesday nightWednesday nightThursday nightFriday nightSaturday nightMaybe nights explanation: *Explanation, if any, regarding availability♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎PreviousNextCONTACT INFORMATIONApplicant Phone *Applicant Other PhoneApplicant Email *Applicant Current Address *Address Line 1Address Line 2CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeApplicant Permanent Address (if different)Address Line 1Address Line 2CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎PreviousNextPAST EMPLOYMENTMost Recent EmployerName of Employer #1 (most recent) *Position(s) Held (Employer #1) *Start Date (Employer #1) *End Date (Employer #1) *Reason for Leaving (Employer #1) *Reason for LeavingStill workingFound a better jobMovedWas laid offWas firedPersonalBad work environmentOtherStreet Address (Employer #1) *City (Employer #1) *State (Employer #1) *StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code (Employer #1) *Phone (Employer #1) *Explanation, if any (regarding Employer #1)♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎Second Most Recent EmployerName of Employer #2 (second most recent)Position(s) Held (Employer #2)Start Date (Employer #2)End Date (Employer #2)Reason for Leaving (Employer #2)Reason for LeavingStill workingFound a better jobMovedWas laid offWas firedPersonalBad work environmentOtherStreet Address (Employer #2)City (Employer #2)State (Employer #2)StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code (Employer #2)Phone (Employer #2)Explanation, if any (Employer #2)♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎Third Most Recent EmployerName Employer #3 (third most recent)Position(s) Held (Employer #3)Start Date (Employer #3)End Date (Employer #3)Reason for Leaving (Employer #3)Reason for LeavingStill workingFound a better jobMovedWas laid offWas firedPersonalBad work environmentOtherStreet Address (Employer #3)City (Employer #3)State (Employer #3)StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip Code (Employer #3)Phone (Employer #3)Explanation, if any (Employer #3)♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎PreviousNextEDUCATIONLast High School Attended *City (Last High School) *State (Last High School) *StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDid you graduate high school? *Graduate?YesNoLast College/University AttendedCity (Last College/Univ)State (Last College/Univ)StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDid you graduate Last College?College Graduate?YesNoMajor Area of StudyDegree Achieved (Last College)DegreeNoneAssociateBachelor'sGraduatePost-GraduateExplanation, if any, regarding education♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎♦︎PreviousNextREFERENCESName (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) ★★★★★★★★★★★★★★★★★★★PreviousNextCERTIFICATIONI 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 SignatureDate / Time of Signature *DateTimeSubmit Facebook Twitter Instagram 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. 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.
