Job Application Form

1245 Lewis River Road, Woodland, WA 98674

Job positions we are currently taking applications for:

Dishwasher/Host ~ Part Time

Applicants must be available to work
Weekdays and Weekends
Business Hours: 7am – 3pm
Work Hours: 6:45AM – Closing and Clean up

Washington Food Handlers Card required.
Food Worker Card (also called a Food Handler Permit) required.
For more information on the Food worker card click on this link
Washington State requires that all food workers have food safety training before handling food served to the public. Food workers who take a food safety training class and pass the State of Washington exam on food safety basics are issued a Food Worker Card (also called a Food Handler Permit). https://www.foodworkercard.wa.gov/

You must select a choice and fill in all fields marked (required) with N/A if you have no information to add, than click submit when completed.

Thank you for your interest in working at Rosie’s 

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First Name(required)

Last Name(required)

Street(required)

City, State and Zip Code(required)

Email(required)

Home Phone Number(required)

Cell Phone Number(required)

Can we contact you via text messages to your cell phone number listed above?(required)

Yes No

What Job position are you applying for?(required)

Cook Prep Cook Server Host Dishwasher

What are your looking for Part Time or Full Time work?(required)

Part Time Full time

If you are under age 18, can you supply proof of eligibility to work?(required)

Yes No

If needed for the job are you older than? (check one)(required)

14 15 16 17

How many hours a week are you looking for?(required)

What is your minimum expected Starting Wage?(required)

What days of the week are you available?(required)

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Can you perform well in a fast-paced service environment?(required)

All the time Most of the Time Never Don't Know No Experience

Are you able to perform the essential duties of the position for which you are applying with or without reasonable accommodation(s)?(required)

YES NO

How did you hear about us?

Select one option Work Source Social Media Friend or Family Referred by a current team member

If referred by a current team member, who referred you?

Why would you like to work for Rosie’s?(required)

Have you ever been employed with Rosie’s?(required)

YES NO

If yes, when?

What Position?

Have you ever worked in the food and hospitality industry?(required)

YES NO

If yes, where did you work and how long?

If yes, what do you enjoy most about working in the food and hospitality industry?

Additional Experience, Skills or Training.

Please list any additional experience, skills or training which you believe should be considered in evaluating your qualifications for employment:

Do you have a current Food Handlers Card for Washington State?(required)

YES NO

Are you Authorized to work in the US?(required)

YES NO

Do you have reliable transportation?(required)

YES NO

If needed on your days off, would you be able to fill in?(required)

YES NO

If no, please explain?

Are you willing to wear a uniform and follow grooming standards?.(required)

YES NO

Are you willing to do tasks outside of your job description which may include other side duties.(required)

YES NO

Do you have experience handling cash and providing change?(required)

YES NO

If hired for a position, what is the earliest date you can start?(required)

Are you currently employed?(required)

YES NO

If Yes, are you planning on working both jobs?(required)

YES NO

Please provide your employment history for the past 10 years: starting with your most current job. (If no previous Employment History type N/A in each box below to submit application.)

Do you have previous Employment History(required)

YES NO

Company Name(required)

Address(required)

Phone(required)

Your Position(required)

Duties (required)

Starting Salary: (required)

Ending Salary: (required)

Supervisor(required)

Dates of Employment (Start Date) (YYYY-MM-DD)(required)

Dates of Employment (Last Date) (YYYY-MM-DD)(required)

Reason for Leaving?(required)

May we contact your previous employer?(required)

YES NO

Company Name(required)

Address(required)

Phone(required)

Your Position(required)

Duties(required)

Starting Salary: (required)

Ending Salary: (required)

Dates of Employment (Start Date) (YYYY-MM-DD)(required)

Dates of Employment (Last Date) (YYYY-MM-DD)(required)

Reason for Leaving?(required)

Other Details (more employment information)(required)

May we contact your previous employer?(required)

YES NO

Company Name

Address

Phone

Your Position

Duties

Starting Salary:

Ending Salary:

Dates of Employment (Start Date) (YYYY-MM-DD)

Dates of Employment (Last Date) (YYYY-MM-DD)

Reason for Leaving?

Other Details (more employment information)

May we contact your previous employer?

YES NO

If you are currently attending school select the type of school you are attending:(required)

Full Time School Virtual school Homeschool N/A – Graduated

Select your Highest level of education:(required)

8th grade or less 9th grade 10th grade 11th grade 12th grade Graduated high school/obtained GED

College education:(required)

None Some college/university Associates Degree/Cert Bachelor’s Degree Master’s Degree or higher Trade School

College, University or Trade School Name, City, State/Providence, College Country

Describe Course of study

Personal or Business Reference

Name

Business

Phone

Address

Relationship

Years know

Personal or Business Reference

Name

Business

Phone

Address

Relationship

Years know

Are you able to speak and read English?(required)

YES NO

Are you willing to relocate?(required)

YES NO

Questions or Comments

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You must select a choice and fill in all fields marked (required) with N/A if you have no information to add, than click submit when completed.

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