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29 views

Application

Uploaded by

api-247040108
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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!

Employment Application
Address:

COMPANY OR EMPLOYER NAME:


Teluwut Bar and Grill Cresco, IA

Position applying for:

Server

EMPLOYEE INFORMATION
Zoie Name: Stapelkamp Last First 1-641-390-0641 Telephone: Email: [email protected]
1101 2nd Ave South Northwood, IA 50459
If necessary for the job, I am able to: X Yes No Work overtime? Yes Provide a valid Alaska Driver's License? X No If so, fill out the following: Issuing state: N/A N/A Type: Endorsement(s):
Hazardous Material Tankers School Bus No Passengers Tank with Hazardous Materials Double/Triple trailers Swing Rotating

Marie
Middle Alternate telephone: N/A

Are you able to perform the essential functions of the position with or without accommodations?

X Yes
14

No 15 19 No 16 21 (Check one)

If necessary for the job are you older than:

X 18
X Yes

I am legally eligible for employment in the U.S.? I am seeking a permanent position:

X Yes

Work the following shifts: (check all that apply)

I will be able to report to work 1 days after being notified I am hired.

X Any
Split

Day

Night Other:

Graveyard

EMPLOYMENT HISTORY
List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extra sheet of paper if necessary. No more than 10 years history recommended.

Employer name and address:

Diamond Jo Casino Worth 777 Diamond Jo Ln, Northwood, IA 50459 Pay: $ 9.56 Per: Hour
Employer name and address:

Position title/duties, skills: Host

Start date:

Charge people to eat, take and give back money, run register, and seat people, always smile and thank the customer.
Supervisor: Jackie Schultz Telephone: 641-323-7815 Position title/duties, skills: Server

May 2012

End date:

Present

Reason for leaving:

Start date:

End date:

Diamond Jo Casino Worth 777 Diamond Jo Ln, Northwood, IA 50459 Pay: $ 6.24 Per: Hour
Employer name and address:

Go talk to our customers, take drink orders, see if they need rells, check up on them, pre-bus, clean the table and re-set it.
Supervisor: Jackie Schultz Telephone: 641-323-7815 Position title/duties, skills: Dishwasher

May 2012

Present

Reason for leaving:

Start date:

Diamond Jo Casino Worth 777 Diamond Jo Ln, Northwood, IA 50459 Pay: $ 9.30 Hour Per:
Employer name and address:

Have to load and unload the dishwasher, lift heavy things, put dishes away, and clean the dishwasher.
Supervisor: John Kern Telephone: 641-323-7663 Position title/duties, skills: Busser

Aug. 2011 May 2012

End date:

Reason for leaving:

I wanted to make tips and have the opportunity to deal with customers.
Start date:

Diamond Jo Casino Worth 777 Diamond Jo Ln, Northwood, IA 50459 Pay: $ 9.07 Per: Hour
Rev. 8/2010

Assist servers when needed, roll silver wear, pre-bus, and re-set tables.

May 2011

Aug. 2011

End date:

Reason for leaving:

Supervisor: Jackie Schultz Telephone: 641-323-7815


Employment Application

Being I was 15 and going by law they transferred me to dishwashing for hours.
Page 1 of 2

!
Summarize other employment related to this job:

EDUCATION
Institution name High school College/university Business/technical Additional
Northwood-Kensett Jr./Sr.

Years completed
4
General

Field of study

Graduate or degree
Graduate May of 2014

MILITARY
Are you a veteran? Duty/specialized training: Yes
N/A

x No SKILLS & QUALIFICATIONS

Other qualifications such as special skills, abilities or honors that should be considered:
N/A

Types of computers, software, and other equipment you are qualified to operate or repair:
N/A

Professional licenses, certifications or registrations:


N/A

Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employers attention:
N/A

Typing speed: N/A

per minute

REFERENCES
List two personal references who are not relatives or former supervisors.

Dan Tenold
Name

200 3rd St. N. Northwood, IA 50459


Address

641-390-8964
Telephone

John Deer
Occupation

8
Years known

Dani Janssen
Name

206 12th St. S. Northwood, IA 50459


Address

641-390-8749
Telephone

Account Team at Diamond Jo


Occupation

2
Years known

CONTACT
In case of accident or illness, please contact: Name: Carrie Stapelkamp Address: 1101 2nd Ave South Northwood, IA 50459 Daytime phone: 641-330-6764 Relationship: Parent

INFORMATION TO THE APPLICANT


As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or a drug test, or to sign a conflict of interest agreement and abide by its terms. I understand and agree to the information shown above.

Zoie Stapelkamp

2/6/14

Signature of Applicant

Date

Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This information is optional and failure to provide it will have no affect on your application for employment. Developed at employer request by the Alaska Department of Labor & Workforce Development, Employment Security Division. Rev. 8/2010 Employment Application Page 2 of 2

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