Atomic Cafe - Employment Application
Personal Information
First & Last Name *
Your answer
Email *
Your answer
Cell Phone Number *
Your answer
Current Address *
Your answer
Are you 18 years of age or older?* *
Atomic is required to comply with city, state, and federal labor laws.
Desired Employment
Which position(s) are you interested in? *
Select all that apply
Required
Full Time or Part Time? *
Desired wage per hour
Your answer
Desired hours per week
Your answer
Are you employed now? *
If so, may we inquire who is your present employer?
Your answer
Availability
Please let us know your availability for the following days (ex. Monday 6am-3pm, Tuesday unavailable, etc).
Monday
Your answer
Tuesday
Your answer
Wednesday
Your answer
Thursday
Your answer
Friday
Your answer
Saturday
Your answer
Sunday
Your answer
Education
What is the highest degree, or level of school you have completed? *
Please let us know the name, location, if you graduated, and if so with what degree.
Your answer
Special training or skills that you believe qualify you for this position:
Your answer
References
Please list three.
Reference #1
Include name, relationship, years known, and telephone number.
Your answer
Reference #2
Include name, relationship, years known, and telephone number.
Your answer
Reference #3
Include name, relationship, years known, and telephone number.
Your answer
Present & Past Employment
Please list three most recent.
Company #1
Please give us some information about Company #1.
Name, Address, and Number
Include company name, address, and phone number.
Your answer
How long did you work at Company #1?
Include start and end dates.
Your answer
Why did you leave Company #1?
Your answer
What were your duties at Company #1?
Your answer
May we contact Company #1?
Company #2
Please give us some information about Company #2.
Name, Address, and Number
Include company name, address, and phone number.
Your answer
How long did you work at Company #2?
Include start and end dates.
Your answer
Why did you leave Company #2?
Your answer
What were your duties at Company #2?
Your answer
May we contact Company #2?
Company #3
Please give us some information about Company #3.
Name, Address, and Number
Include company name, address, and phone number.
Your answer
How long did you work at Company #3?
Include start and end dates.
Your answer
Why did you leave Company #3?
Your answer
What were your duties at Company #3?
Your answer
May we contact Company #3?
Other Information About You
Ok, here is your chance to tell us something that you think is really great. It can be about you, or about someone or something you love. We want to know what makes you really happy.
Your answer
If there's anything else you would like us to know about you, please note it here.
Your answer
If there's anything else you would like us to know about you, please note it here.
Your answer
Within the last 7 years, have you ever been convicted of a crime?
*Crimes include felonies, misdemeanors and other violations of the law. However, you should not respond “yes” as a result of any conviction that has been judicially sealed, expunged or pardoned. Conviction of a crime will not necessarily disqualify you from consideration for employment and will be considered only as it relates to the job in question.
Atomic Cafe Agreement
Nature of My Employment:

If Atomic Cafe hires me, I agree that I will be an at-will employee, which means that either Atomic Cafe or I may end employment at any time, with our without cause or notice. I agree that if hired, I will obey Atomic Cafe rules, including treating confidentially any information I learn during my employment.

My Records and References:

I authorize Atomic Cafe to conduct reference checks, either personal or professional.

Information Certification:

I certify that the information I have provided is true and complete. I agree to notify Atomic Cafe if I am later charged or convicted of any crimes. I agree that any false information or omission allows Atomic Cafe to refuse to hire me, or to terminate my employment at any time.
Application Signature *
Please type your name, and date below. This will act as an electronic signature.
Your answer
Equal Opportunity Employer
Atomic Cafe is an equal opportunity employer.

Our managers review applications daily. If your application fits our criteria you will be contacted to set up an interview.

Thank you!
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