Thank you for your interest in applying at the Riverside Icehouse. Please fill out the following form as completely as possible. Pre-Employment Questionnaire Equal Opportunity Employer Todays Date is 2012-05-20 Step 1: Applicant Info Name Email Address Phone No. Referred by Present Address City State Zip Code Click here if your permanent address is the same as your current. Permanent Address City State Zip Code Step 2: Employment Desired Type:     Full TimePart Time Position: AnyKitchen ManagerWait StaffBartenderCook Date You Can Start Salary Desired Are you Employed Yes No If So, May We Inquire Of Your Present Employer     Yes No Step 3: Education History Check if N/A Name & Location of School Years Attended Did you Graduate? Subjects Studied Grammer School YesNo High School YesNo College YesNo Trade, Business, Correspondence School YesNo Step 4: General Info Subjects of Special Study/Research Work or Special Training Skills US Military or Naval Service Rank Step 5: Employment History Date Start Date End Employer Name & Address Salary Position Reason for Leaving Step 6: References Please provide references upon request.