Petrow's Restaurant Application for Employment						Date:_______
Name:___________________________				If Under 19, Please List Age:__________
Address:_________________________				Phone #:_______________
Position Applying For (Check One)
Waiter/Waitress:
Cook:				School Most Recently Attended
Prep-Cook:				School Name:
Soda Fountain:				Address:
Host/Hostess:				Councelor:
Dishwasher:				Last Grade Completed:
Busser:				GPA:
Most Recent Employment
Company:_________________________				Address:________________	Phone:____________________
Position:__________________________				Supervisor:________________________
Dates Worked:____________________
Physical Information
Any Health or Physical limitation which could affect your employment?					Yes:_______ No:_______
If Yes, Please Explain:
In Case of Emergency Notify:
Name:___________________		Phone:________________
Address:________________________________
City:_________________	State:_____			Zip:__________
I certify that this information is accurate and complete.  Giving incomplete or false information
in an application for employment is a serious matter and is grounds for dismissal.  I hereby
acknowledge notification that Petrow's Restaurant may request information regarding my character.
Date:__________________ Signature:_________________________________
Available Hours:
SUN_________MON_________TUES_________WED__________THURS_________FRI_________SAT_________