Online Job Application Form Abbreviated Date MM DD YYYY APPLICANT INFORMATIONFirst NameM.I.Last NameAddress Street Address Apartment/Unit # City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Days of week not available for workTimes of year not available for workEDUCATIONHigh SchoolAddressAttended fromtoDid you graduate? Yes No Additional educationAddressAttended fromtoDid you graduate? Yes No DegreeAdditional Education InformationREFERENCESPlease list a personal reference.Full Name RelationshipPhoneAddressCURRENT/PREVIOUS WORK OUTLINECompany #1PhoneAddressSupervisorResponsibilitiesFromtoIs this a current or previous position?May we contact your previous supervisor for a reference? Yes No Company #2PhoneAddressSupervisorResponsibilitiesFromtoIs this a current or previous position?May we contact your previous supervisor for a reference? Yes No OTHER INFORMATIONPlease answer all questions.Please describe what you feel is special about the Delta Diner.Describe a situation in your life where your involvement in a group effort paid greater dividends than would be possible as an individual:Is the Customer Always Right?Disclosure and SignatureI certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.Full NamePlease type your full name above to electronically sign this application.PhoneThis field is for validation purposes and should be left unchanged.