APPLICATION FOR EMPLOYMENT
An equal opportunity employer
Please print out the application and fill out completely and drop it off at CAFE Z 1705 S 1^ST AVE IOWA CITY, IA 52240

Personal Information
Name (last name, first)___________________________________________________________

Present Address________________________________________________________________

S.S.#______________________________ Phone #____________________________________

Availability
Total hours available per week_________. Please indicate the time you are available for work each day.

Do you have a dependable way to get work? Yes No Please explain ___________________________

Education
Are you currently attending school? ________ Name of school? _____________________

Former Employers (Starting with the last one)

References (Two people not related to you, whom you have known at least one year)

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

Signature________________________________ Date ___________________________