Employment application Application for Employment Position Applying For:*Name:*Do you have reliable transportation to get to and from work?YesNoDate of Birth Address*Street AddressCityState / Province / RegionZIP / Postal CodeSocial Security Number:Home Phone:*Cell Phone:Other Phone:Are you eligible to work in the United States?YesNoAre you 18 years of age or older?YesNoIf NO, what is your current age?If you are a student, are there any activities that will hinder you from working?YesNoHow did you learn about this employment opportunity at The Popcorn Bar?Job Bulletin (Posting)Walk-inWebsiteNewspaperReferral by employeeIf YES, state activity and dates not able to work.EDUCATIONHigh School: City/StateDid you graduate High School?YesNoHow many years attended?Date of Graduation High School College: City/StateDid you graduate College?YesNoHow many years attended?Date of Graduation College GEDCity/StateDid you graduate GED?YesNoHow many years attended?Date of Graduation GED Other credentials/ licenses/ affiliations, etc., which are relevant to the job(s) for which you are applying.SKILLS:Please list any skills, abilities, or knowledge you feel might be useful in applying for this job.WORK EXPERIENCEName/Address of Employment:Title:Starting Salary:Final Salary:Did you workPart timeFull timeDate of Employment: From: To: Supervisor’s Name and Phone NumberOther Reference Name, Title, and Phone # to Contact:Primary duties:Reason for Leaving:PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION. I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize The Popcorn Bar to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon offer of employment or anytime during employment.