Barflyy Employment Application
Barflyy is an equal opportunity employer and it complies with all discriminatory laws. Information requested on this application will not be used for any purpose prohibited law. It is the policy of Barflyy Retro Bar and Arcade to hire only individuals authorized to work in the United States.
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Name
Birthdate
MM
/
DD
/
YYYY
Social Media
Street Address
City, State, Zip code
Phone Number
Email
Name any Referrals/ References
Which job are you applying for?
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Wage Rate Required ( per hour)
If you are applying for a server/ bartender position, are you old enough to serve or handle liquor, and will you be able to establish that age if offered a job?
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Total hours needed per week
Do you have transportation to work?
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Can you work overtime?
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Select the days you CAN work?
MON
TUE
WED
THURS
FRI
SAT
SUN
PM
To comply with Federal Law, will you be able to establish your right to work?
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Have you ever been fired?
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If you answered yes to the above question please explain.
Have you been convicted of a felony within the past ten years? (a conviction of this type does not necessarily bar you from consideration for employment)
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If you answered yes to the question above please explain.
Are you able to perform the essential functions of the job for which you are applying?
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If you are applying for a position in which you will be serving or preparing food, do you have hepatitis A, Salmonella Typhi, or any other illness which may be spread by contact with food
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If you answered yes to the question above please explain
Have you ever applied at Barflyy?
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If you answered yes to the question above please provide date and location.
Have you ever worked for Barlfyy?
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If you answered yes to the question above please provide start date and location.
Please choose the highest grade completed
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Name of school, Location, Course of study
Employment History ( List the three most recent jobs, full-time and/or part-time, including military if applicable with most recent first)
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May we contact your current employer?
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Company  #1 Company Name
Company #1 Address (street, city, state)
Company #1 Phone Number
Company #1 Dates of Employment
Company #1 Name of Supervisor
Company #1 Job Title- Describe your work
Company #1 Rate of Pay
Company #1 Reason for leaving
Company  #2 Company Name
Company #2 Address (street, city state)
Company #2 Phone Number
Company #2 Dates of Employment
Company #2 Name of Supervisor
Company #2 Job Title- Describe your work
Company #2 Rate of Pay
Company #2 Reason for leaving
Company  #3 Company Name
Company #3 Address (street, city, state)
Company #3 Phone Number
Company #3 Dates of Employment
Company #3 Job Title- Describe your work
Company #3 Name of Supervisor
Company #3 Rate of Pay
Company #3 Reason for leaving
I certify by checking the box below that the information provided in this application by me is correct to the best of my knowledge and I understand that deliberate falsification or misrepresentation of information is grounds for denial of employment or immediate dismissal. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties of all liability for any damage that may result from furnishing information to you. I understand that nothing contained in this employment application or in the granting of an interview created an employment contract between Barflyy Bar and Arcade and myself for either employment or for the providing of any benefit. If any employment relationship is established, I understand that I have the right to terminate my employment at any time and that Barflyy retains the same right. *
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