DQ®  Employment Application
Application Information
Restaurant
Location
Position
Personal Information
Last Name
First Name
Middle Initial
Present Address
Phone Number
Cell Phone Number
E-mail
Are you 18 years of age or older?
YES
 NO
If not 18 or older, how old are you?
Do you have reliable transportation to
work?
NO
YES
Have you ever been convicted for
anything other than a minor traffic
violation?
NO
YES
If yes, please explain in detail
What type of employment are you interested in?
Availability
Please list the hours you are available to work on the days listed below.   If you
can work any hours for a given day, just check the "open" box for each day you
have open availability.
Monday
from
to
open
Tuesday
from
to
open
Wednesday
from
to
open
Thursday
from
to
open
Friday
from
to
open
Saturday
from
to
open
Sunday
from
to
open
How many hours per week would you like to
work?
Acceptable starting wage
$
per
HOW WOULD YOU RATE YOURSELF
1= Improvement needed     2=OK    3=Good  4=Top Performer
Energy Level:  Your sense of urgency, self motivation, and
enthusiasm
Communication: Your ability to listen well. express ideas clearly and
accept feedback
Hospitality: Your natural friendliness and customer service skills
Reliability: Your dependability, attendance, self discipline, and
dedication
Personal Pride: Your appearance, hygiene and achievement.
Teamwork: Your cooperation with others and team spirit
What achievements are you most proud of?
What are your personal strengths?
What are your weakest areas?
What are your five year goals?
Why do you want to work here?
Employment History
Employer 1
Previous Employer
Previous Employer Address
Supervisor Name
Employment Dates
From
To
Month
Year
Month
Year
Ending wage $$
Reason for leaving
May we contact this employer?
NO
YES
Employer 2
Previous Employer
Previous Employer Address
Supervisor Name
Employment Dates
From
To
Month
Year
Month
Year
Ending Wage $$
Reason for leaving
May we contact this employer?
YES
 NO
Education
Highest Grade Completed
(select one)
School Attended