Job Inquiry Form

What location are your interested in working ?
Chanhassen Chaska Excelsior Buffalo
Name (Last) (First) (Middle)
Address:
City: State: Zip:
Home Telephone: Cell or Business Telephone:
If you are under 18 years of age, please state your date of birth:
May we contact you at work?
Yes No
Positions Applying For:
(check all that apply)
Ticket Sales Attendent
Concession Sales Attendant Projection Booth Operator
Usher
Asst Manager/Supervisor Manager
Sales And Marketing Maintenance Staff  
Are you interested in?
(check all that apply)
Full Time Part Time Temporary Summer Only
Date you are available to start work:
Our theaters are open 365 days a year. Please check any days and shifts you would NOT be able to work.
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
Day Day Day Day Day Day Day
Evening Evening Evening Evening Evening Evening Evening

EDUCATION
School Name and Location of School # of years Graduated? Degree/Area of Study
High School Yes No
College Yes No
Graduate School Yes No

SPECIAL SKILLS
Do you have any experience with the following equipment: (Check all that apply)
Cash Registers Computers Concession Equipment Projection Equipment

LEGAL
Are you a U.S. Citizen? Yes No
-- if no, do you have the legal right and necessary documents to work in the U.S. Yes No
Were you ever discharged by any company? Yes No
If yes, give the name of the company
Reason for discharge
Have you ever been convicted of a crime other than a traffic violation? Yes No
If yes, please explain the offense and final disposition of the case:

EMPLOYMENT HISTORY
Employer 1 Employer 2 Employer 3
From:
To:
Employer:
Address:
City:
State:
Zip:
Phone:
Wage: $ /hr
Position:
Reason for Leaving:
From:
To:
Employer:
Address:
City:
State:
Zip:
Phone:
Wage: $ /hr
Position:
Reason for Leaving:
From:
To:
Employer:
Address:
City:
State:
Zip:
Phone:
Wage: $ /hr
Position:
Reason for Leaving:

REFERENCES
Name Address Work Phone Years Known
Address:
City: State: Zip:
Address:
City: State: Zip:
Address:
City: State: Zip:

PLEASE READ CAREFULLY
Various Federal, State, and Local Laws prohibit discrimination based on race, sex, religion, national origin, age or disability. Five Star Cinemas is an EQUAL OPPORTUNITY EMPLOYER and your response to any question will NOT be used as a basis for discrimination, but will be judged on its relevance to the position you are seeking. In submitting this application for employment, I understand that an investigation may be made whereby information is obtained regarding my character, previous employment, general reputation, educational background, credit record and/or criminal history. I authorize anyone possessing this information to furnish it to Five Star Cinemas and/or a third party company upon request and I release anyone, and any third party company from all liability and damages whatsoever in furnishing, obtaining, or using said information. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in immediate dismissal. I understand, also, that I am required to abide by all rules and regulations of Five Star Cinemas, LLC. Thank you for completing this application and for your interest in employment with us. We would like to assure you that your opportunity for employment will be based only on your ability and on no other consideration. Please double-check all the information you entered above and verify that it is all correct before submitting the application.

Signature of Applicant
(Please type your full name)
Date