Dominick's Menus Dominick's Wine Dinners 2 Locations - Historic Norcross & Lawrenceville
Online Application
For Roswell Location ONLY
 

Last Name
First
M.I.
Date
Street Address
Apartment/Unit#
City
State
Zip
Phone Number
Email Address
Date Available
Desired Salary
Position Applied For
Are you a citizen of the United States?
YES NO
If no, are you authorized to work in the U.S.?
YES NO
Have you ever worked for Dominick's?
YES NO
If so, when?
Have you ever been convicted of a Felony?
YES NO
If yes, please explain
 
Education
High School
Address
From
To
Did you graduate?
YES NO
Degree
College
Address
From
To
Did you graduate?
YES NO
Degree
Other
Address
From
To
Did you graduate?
YES NO
Degree
 
 
References
Please list three (3) professional references
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
 
Previous Employment
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for leaving?
May we contact your previous supervisor for a reference?
YES NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for leaving?
May we contact your previous supervisor for a reference?
YES NO
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason for leaving?
May we contact your previous supervisor for a reference?
YES NO
 
Military Service
Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable, explain
 
Availability

Select all shifts, AM and/or PM that represent the shifts that you are available for working by placing a check in the appropriate boxes. Also remember the availablity you were hired under. This is not a request form. This is a documentation of what you are available for. Any changes past or future to this record can affect the amount of shifts you receive.
Monday
AM    PM		 Tuesday
 AM    PM		 Wednesday
AM   PM		 Thursday
 AM   PM		 Friday
 AM   PM		 Saturday
PM		 Sunday
 PM
And remember that everyone must have Sunday availability.
 
Disclaimer

I 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.
I Accept: Name:

 
 
 
 

 

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