Buster's Liquors & Wines

First Name \ Middle Name

Last Name

Address

City / State / Zip

Phone

Email Address

Are you over 21 years of age?

Yes

No

Emergency Contact / Phone

Position Desired (check all that apply)

Wine Sales

Liquor Sales

Cashier

Full Time

Yes

No

(Fulltime status at Buster's Liquors requires the employee to work 35 or more hours a week.)

Desired Hourly Wage

Desired Hours Per Week

Desired Start Date

Are you acquainted with anyone who has worked with Buster's Liquors?

Yes

No

Who?

Have you applied with this company before?

Yes

No

When?

How did you learn about this position?

Monday from

to

Tuesday from

to

Wednesday from

to

Thursday from

to

Friday* from

to

11pm

Saturday* from

9am

to

11pm

Sunday* from

11am

to

6pm

Please indicate highest education level.

GED

High School

Some college

Bachelors

Masters

Name of Institution, Year Graduated

Major or Area of Focus

Are you currently employed?

Yes

No

May we contact your current employer?

Yes

No

Current Employer, Supervisor Name

Address, City, State, Phone

Position, Rate of Pay

Past Employer, Supervisor Name

Address, City, State, Phone

Position, Rate of Pay

Reason for leaving

Past Employer, Supervisor Name

Address, City, State, Phone

Position, Rate of Pay

Reason for leaving

Name

Relationship / Years Known

Phone

Name

Relationship / Years Known

Phone

Name

Relationship / Years Known

Phone

Have you ever been convicted of a crime that has not been expunged, erased, discharged or sealed by the court?

Yes

No

If yes, please list city, state, year of offense, whether offense was a felony or misdemeanor, and description of offense.

This position requires lifting up to 50 lbs. Are you able to fulfill this requirement with or without accommodation?

Yes

No

Job Application

Personal Information

Job Information

Hours

*Availability required for weekend shifts

Education

Employment History

References

Reference 1

Reference 2

Reference 3

Are you 21 years old, or older?