Application For Employment
Name: Date: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2008
Street Address: Home Phone:
E-Mail Address: Cell Phone:
Date Of Birth: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 Position Applying For: -Select One- Bartender Barback Dancer DJ Janitorial
Work History:
Last Employer: Phone:
Position Held: Date Left:
Reason For Leaving:
Educational History:
Last School Attended:
Current Status: -Select One- High School Graduate College Graduate Bachelors G.E.D. Still Attending School
Please list any skills that may help us in considering your request for employment:
The Stampede Club and its subsidiaries are an Equal Opportunity Employer and does not discriminate. Nor do we base our employment decisions on any of the following: *Age (as permitted by law), Sexual Gender, Race, Religion, Financial Status, Marital Status, or Sexual Orientation.
By signing below and clicking "Submit", I certify that all of the information I have provided is true and correct to the best of my knowledge. I further understand that any false information given intentionally may result in immediate termination of my employment should I be given a position of employment.
Signature: Date Signed: