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Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you at least 18 years of age? *

Yes
No

What position are you applying for? *

Expected Pay? *

$______/hr

Part Time
Full Time

What date can you start? *

If employed, do you expect to work elsewhere? *

Yes
No

Availability (check all that apply) *

Are you available to work overtime? *

Yes
No

Are you available to work holidays? *

Yes
No

Do you have reliable means. of transportation to and from work? *

Yes
No

If hired, can you verify that you have the legal right to work in the United States? *

Yes
No

Have you been convicted of, pleaded guilty to, or pleaded no contest to, any criminal offense (felony or misdemeanor) within the last 5 years? Convictions for marijuana offenses that are more than 2 years old need not be listed. No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, date of offense, the surrounding circumstances and the relevance of the offense to the position applied for may, however, be considered *

Yes
No

How did you find out about our organization? *

Do you have any family or friends working for our organization? *

Yes
No

Work History

Employer (list most recent job first): *

Employer Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Employer Phone: *

What dates did you work there? *

From (mm/yy) - To (mm/yy)

Wages: *

$_____/hr

Job Title: *

Reason for Leaving: *

Describe the work you did: *

Employer #2:

Employer #2 Address:

Address Line 1

Address Line 2

City

State

Zip Code

Employer #2 Phone:

What dates did you work there?

From (mm/yy) - To (mm/yy)

Wages:

$_____/hr

Job Title:

Reason for Leaving:

Describe the work you did:

Employer #3:

Employer #3 Address:

Address Line 1

Address Line 2

City

State

Zip Code

Employer #3 Phone:

What dates did you work there?

From (mm/yy) - To (mm/yy)

Wages:

$_____/hr

Job Title:

Reason for Leaving:

Describe the work you did:

List two references (not relative or former employer) who you have known for at least 5 years:

References

Reference #1 *

First

Last

Phone *

Business: *

Years Acquainted: *

Reference #2 *

First

Last

Phone *

Business: *

Years Acquainted: *

Education

Did you go to high school? *

Yes
No

Did you go to college? *

Yes
No

What languages do you understand, speak, read or write fluently? *

Are you willing and able to comply with all requirements listed? *

Conditions of Employment:

Tap & Vine @ the White House sets high standards for its employees. Compliance with these standards is a condition of employment. If you are offered a position, you need to carefully consider what we would require of you before you accept. Job expectations include the following: *

Are you willing and able to comply with all requirements listed? *

Yes
No

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