A Slice of Spain In
Historic Downtown Frederick
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301.698.8922
44 N. Market Street
Frederick, MD 21701

Application

* Indicates Required Field

Date *

First Name *

Last Name*

Address 1*

Address 2

City *

State *

Zip*

Phone*

Email *

Positions Applied for*

Salary Desired*

Availability

Days/hours available to work:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Employment Desired*

 Full-Time Only Part-Time Only Full or Part Time

When available to begin work?*

Education

High School

Name of School

Address

Years Completed

Diploma

 Yes No

College

Name of School

Address

Years Completed

Major & Degree

Business or Trade School

Name of School

Address

Years Completed

Major & Degree

Professional School

Name of School

Address

Years Completed

Major & Degree

Other

Name of School

Address

Years Completed

Major & Degree

References

Please list two references other than relatives.

Reference #1

Name

Telephone

Relationship

Reference #2

Name

Telephone

Relationship

Reference #3

Name

Telephone

Relationship

Previous Employment (list up to 3)

Employer #1(Most Recent)

Emplyer Name

Employment Dates

From: To:

Salary

Phone Number

Last Job Title

Reason for leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your employer

 Yes No N/A

Employer #2

Emplyer Name

Employment Dates

From: To:

Salary

Phone Number

Last Job Title

Reason for leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your employer

 Yes No N/A

Employer #3

Emplyer Name

Employment Dates

From: To:

Salary

Phone Number

Last Job Title

Reason for leaving (be specific):

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your employer

 Yes No N/A

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