Duffer's Restaurant Employment Interest Form 
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Name *
First and last name
Email *
Date of Birth  *
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DD
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Phone number *
Address *
Which position(s) are you interested in? Please select all that apply *
Required
Date you can start: *
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DD
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Last available date to work: *
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DD
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YYYY
If last day available to work is before September 22, 2024. Please explain why?
Employment History (Provide previous employers name, location, your job title, and dates of employment) *
High School/College Name:
Please provide year graduated or graduating.
*
Employment Reference (Name & Phone Number) *
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