EMPLOYMENT  APPLICATION

THE  RIVOLI  THEATRE,  INC.

NAME:___________________________________________ BIRTH DATE___/___/___

LOCAL STREET ADDRESS_________________________________________________

CITY________________________________STATE_______________ZIP____________

HOME STREET ADDRESS__________________________________________________

CITY________________________________STATE_______________ZIP____________

CELL NUMBER__________________________________________________________

EMAIL__________________________________________________________________

FACE BOOK___________________________________

HOW MANY HOURS A WEEK DO YOU WANT TO WORK?______

WHICH ONE WEEKDAY NIGHT ARE YOU AVAILABLE TO CLOSE AT OR NEAR

MIDNIGHT_____________

WHICH WEEKEND NIGHT WOULDYOU PREFER TO HAVE OFF?__________

HOW MANY WEEKENDS PER MONTH WILL YOU ASK OFF?____

WHAT OTHER ACTIVITIES DO YOU HAVE OUTSIDE OF THE CLASS ROOM

(Be Specific i.e. Organized Sports, Drama Club, Volunteer Work etc) __________________________________________________________________________________________________________________________________________________

_________________________________________________________________________

DO YOU HAVE A RESPONSIBLE SERVERS LICENSE?______

DO YOU USE TOBACCO PRODUCTS?______

ARE YOU CURRENTLY ENROLLED AS A STUDENT?_______

WHAT IS YOUR CURRENT GPA?_______________

LAST EMPLOYER___________________________________________________________________

CITY______________________________________________PHONE__________________________

SUPERVISOR______________________________________PAY RATE_____________

REASON FOR LEAVING _______________________________________________________________

PREVIOUS EMPLOYER______________________________________________________________

CITY________________________________________PHONE_________________________________

SUPERVISOR_________________________________PAY RATE_________________

REASON FOR LEAVING ________________________________________________________________

The falsification of information or omission of facts herein may be cause for immediate

dismissal. I hereby authorize The Rivoli Theatre Inc. to verify all information provided herein.

SIGNED___________________________________DATE_______________________