| Are you 18 years of age or older ? |
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| Have you ever been convicted of a felony? |
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Tell us when you are
available to work:
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Mon |
Tue |
Wed |
Thu |
Fri |
Sat |
Sun |
| Lunch (9 AM - 2 PM) |
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| Dinner (2 PM - 11 PM) |
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Note: IU
students must submit a copy of your IU Insight schedule each semester.
Name and city of
present or last employer
Job Title
Description of work
Starting Date
(month/year) Leaving Date
(month/year)
Name and title of
supervisor
May we contact
supervisor ? Phone Number
Reason for leaving
Name and city of
previous employer
Job Title
Description of work
Starting Date
(month/year) Leaving Date
(month/year)
Name and title of
supervisor
May we contact
supervisor ? Phone Number
Reason for leaving
Name, address, and telephone number
of three persons not related to you with
whom you have been acquainted for at least one year.
1.

2.

3.

Have you ever eaten at Grazie! ? If so, tell us about your
experience.
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