Application for Employment

Applications can be submitted via this online form or by printing the pdf version and personally bring it to BuffaLouie’s at the Gables – 114 South Indiana Avenue Bloomington ,IN. Please take your time to complete the necessary information required, Thank you.



First Name:
Last Name:
Current Address:
City: State: Zip Code:
Permanent Address:
City: State: Zip Code:
Current Phone Number:
Permanent Phone Number:
Cell Phone Number:
Email Address:

How did you hear about job opportunities at BuffaLouies?
Do you know anyone who is currently employed at BuffaLouies? YesNo
If so, who?
Have you ever been employed by BuffaLouie’s in the past? YesNo
If so, dates of employment:
Reason for leaving:

Are you legally eligible for work in the United States? YesNo
(if hired, verification is required by law)
Have you been convicted of a crime in the last 7 years? YesNo
If yes, please list convictions that are a matter of public record (an arrest is not a conviction). A conviction will not necessarily disqualify you from employment.

Are you of legal age to serve alcohol? YesNo
Do you have reliable means of transportation to work? YesNo


What position(s) are you applying for?
If applying for Delivery Driver, have you been involved in a moving vehicle violation
in the last 7 years? YesNo
(BuffaLouie’s will check the motor vehicle records of any job applicant, in every State of previous employment, when driving is an essential job function)
If yes, please list:
What skills do you have that are applicable to position(s) applied for?


Date available for employment:
If hired, how long do you plan to be employed by BuffaLouie’s?
How many hours are you able to work per week? (BuffaLouie’s is open for business 7 days a week)
Do you have any regularly scheduled or intermittent obligations that may affect your
availability to work? YesNo If yes, please list:
Specify hours available each day of the week:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday


Education

High school
Name and Address of School:
Last year completed: Did you Graduate? YesNo
Subjects studied, Degrees received:

College
Name and Address of School:
Last year completed: Did you Graduate? YesNo
Subjects studied, Degrees received:

Post College
Name and Address of School:
Last year completed: Did you Graduate? YesNo
Subjects studied, Degrees received:

Trade, business or correspondence school
Name and Address of School:
Last year completed: Did you Graduate? YesNo
Subjects studied, Degrees received:


Employment History

Provide information for your last 3 employers starting with the most recent. If never employed, list any volunteer activities

Employer1:
Supervisor:
Position held:
Dates (From: to)
Location:
Phone Number:
Last rate of pay:
Reason for leaving:

Are you eligible for rehire? YesNo

Employer2:
Supervisor:
Position held:
Dates (From: to)
Location:
Phone Number:
Last rate of pay:
Reason for leaving:

Are you eligible for rehire? YesNo

Employer3:
Supervisor:
Position held:
Dates (From: to)
Location:
Phone Number:
Last rate of pay:
Reason for leaving:

Are you eligible for rehire? YesNo


Personal References

Name:
Phone Number:
Occupation:
Relationship: Years acquainted:
 
Name:
Phone Number:
Occupation:
Relationship: Years acquainted:
 
Name:
Phone Number:
Occupation:
Relationship: Years acquainted:
 


BuffaLouie’s provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability or genetics

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