

Name Today's Date:
Social Security Number: Birth Date:
Phone Number:
Address:
Position Applying For:
If applying for a waitress position, are you at least eighteen years old?
If applying for a dishwashing position, are you at least sixteen years
I am generally available to work the following days. **Note that the shift starts at 4:00pm every day and you should expect to
be here for at least one half hour after closing every night.**
DAY/TIME SUN MON TUES WED THURS FRI SAT
START TIME
END TIME
Date I can start work: Salary Expected:
WORK HISTORY
Company Dates (from-to) Supervisor’s Title/Name Type of Work End Rate Reason for Leaving
Most Recent
Second Most Recent
Third Most Recent
My job related skills/experience/personal
traits that would make me a great employee are:
Have you ever been convicted of a crime or ordinance violation or assessed a civil forfeiture (fine)? Answering yes won’t
automatically disqualify you.
If yes, please explain:
EDUCATION HISTORY
Degree/Major G.P.A. No. Years Attended Graduated Yes/No
Graduate School
College
High School
Other
REFERENCES
Name Company Title Address Phone Years Acquainted
I hereby certify that this application and any other materials and/or documents provided in this application process
contain no willful misrepresentation and that the information given is true and complete to the best of my knowledge.
I am aware that should investigation at any time disclose any such misrepresentation or falsification, my application
will be rejected, my name may be removed from consideration, or if employed, I may be discharged from my
employment.
I authorize my current or former employers and all schools or educational and technical institutions which I have
attended to provide The Pasta Shoppe representatives any information regarding my current or former
employment, scholastic records, or ratings. I hereby release any such current or former employers or institutions,
their agents or employees, from any and all liability resulting from the release of such information. My authorization
and release from liability are voluntary acts. This authorization shall be effective for employment investigations by
The Pasta Shoppe only.
E-Signature:
Date:
Application for Employment We are currently looking for energetic individuals to join our team! Position openings include line cook and dishwasher. Hours and wages will vary depending on experience. Please apply today!! Any questions, feel free to call 262-284-9311.
The Pasta Shoppe is an equal opportunity employer. Please answer all of the questions below to be considered. Thank you.
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Application
323 N. Franklin St.
Port Washington, WI
53074
(262) 284-9311