Name *

First Name

Last Name

Phone *

(###)

###

####

Address of Residence *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you authorized to work in the USA? *

Yes

No

Earliest available start date: *

MM

DD

YYYY

Do you have 2 years bartending experience? *

Yes

No

Are you available to regularly work weekends? *

Yes

No

Do you have reliable transportation?

Yes

No

Have you ever visited The Rust Belt Market? *

Never

Occassionally

Regularly

Are you currently a student?

No

Yes, High School

Yes, College / Vocational School

Date of Graduation

MM

DD

YYYY

Date of Graduation / Completion

MM

DD

YYYY

Date of Graduation / Completion

MM

DD

YYYY

Address *

Employer (#1)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Employer (#1)

(###)

###

####

Hire Date *

Employer (#1)

MM

DD

YYYY

Are you still with this employer? *

Yes

No

Address

Employer (#2)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Employer (#2)

(###)

###

####

Hire Date

Employer (#2)

MM

DD

YYYY

Are you still with this employer?

Yes

No

Professional Reference *

First Name

Last Name

Phone *

Professional Reference (#1)

(###)

###

####

At-Will Employment Acknowledgement: *

If hired, the relationship between you and The Rust Belt Market, LLC is referred to as "Employment At-Will." This means your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or by The Rust Belt Market, LLC. No representative of The Rust Belt Market, LLC has authority to enter into any agreement contrary to the foregoing Employment At Will.

I acknowledge and agree

I do not agree