Application For Employment

An Equal Opportunity Employer
Please Note:
 Must be at least 14 years of age to complete this form.

PERSONAL INFORMATION:
 
Last Name:
Middle Name:
First Name:
Over 18 Years of Age?
If hired, and you are a minor, can you get a work permit?
Current Address:
City:
State:
Zip Code:
Day-Time Phone Number:
Night-Time Phone Number:
Cellular Phone Number:
E-Mail Address:
Best way to contact you:
Are You Currently Employed:
If Yes, Position & Location:
If hired are there any special needs your require to perform job duties?
If yes, what are your needs?
Have you ever been convicted of a felony?
If yes, explain:
 
AVAILABILITY:
 
When are you available for interviews?
What is your wage requirement per hour?
Date available to begin work:
Would you work full or part-time?



When are you available?



**We are willing to work with your scheduling needs**

Are there any days or hours that you are unable or unwilling to work?
 
EDUCATION RECORD:
 
Highest grade completed?



List any special skills or professional licenses you have:
Are you a Veteran of the United States Armed Forces?
 
EMPLOYMENT EXPERIENCE:
 
Employer:
Telephone Number:
Job Title:

Supervisor:


Work Performed:


Beginning Hourly Rate:


Final Hourly Rate:


Date Hired:


Date Released:


Reason for leaving?

Employer:
Telephone Number:
Job Title:

Supervisor:


Work Performed:


Beginning Hourly Rate:


Final Hourly Rate:


Date Hired:


Date Released:


Reason for leaving?
 
Employer:
Telephone Number:
Job Title:

Supervisor:


Work Performed:


Beginning Hourly Rate:


Final Hourly Rate:


Date Hired:


Date Released:


Reason for leaving?
 
PERSONAL REFERENCES:
 Non-Relatives You Have Known At Least One Year

Name:


Occupation:


Telephone Number:



Name:


Occupation:


Telephone Number:


 
Date of Application:

Which job duties are you interested in?
Please list all/any that apply.

(Birthday Host/Hostest, Skate Guard, Snack Bar Attendant, DJ)

Comments / Questions:

If you have questions about your application or about a job at High Roller, e-mail us.
DO NOT CALL US! IF YOU CALL US, WE WILL THROW OUT YOUR APPLICATION.

You will receive a PHONE CALL or an E-MAIL
within 72 hours if we are interested.

By submitting application you verify that the information provided is,
to the best of your knowledge, truthful and correct.
You also understand that a criminal backround check may be conducted.