33% of survey complete.

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* 1. Last Name:

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* 2. First Name:

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* 3. Address:

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* 4. City, Sate, Zip:

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* 5. Phone:

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* 6. Email:

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* 7. Operating hours will be Monday through Saturday 7am to 9pm and 8am to 8pm on Sunday. Please list your availability:

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* 8. Are you interested in working:

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* 9. Referred by:

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* 10. Are you at least 18 years of age? (If not, an additional form is required by NC).

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* 11. Are you a US citizen?

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* 12. If not a US citizen, can you provide proof of your legal right to accept employment?

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* 13. Date available for work:

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* 14. Have you ever been convicted of a crime? If yes, give date and reason for conviction:

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* 15. Are you currently employed? If yes, may we contact your current employer?

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* 16. What is your desired pay range?

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* 17. Are you currently a student or have plans of becoming a student in the next year? If yes, where and in what year of completion:

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* 18. Education and Training:

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* 19. Why do you want to work here?

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* 20. What personal qualities, knowledge, or training do you possess that would make you the best choice for the position?

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* 21. What position you are applying for?

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* 23. I am also interested in working in:

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