Applications can be submitted via this online form or by printing the pdf version and personally bring it to BuffaLouie’s at the Gables – 114 South Indiana Avenue Bloomington, IN. Please take your time to complete the necessary information required, Thank you.

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Employee Information

Name *

First

Last

Current Address *

Address Line 1

Address Line 2

City

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Zip Code

Permanent Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Current Phone Number *

Permanent Phone Number *

Cell Phone Number

Email *

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Which location are you applying for?BloomingtonCarmel

How did you hear about job opportunities at BuffaLouies?

Do you know anyone who is currently employed at BuffaLouies?NoYes

If so, who?

Have you ever been employed by BuffaLouie’s in the past?NoYes

If so, dates of employment

Reason for leaving previous employment

Are you legally eligible for work in the United States?YesNo

Have you been convicted of a crime in the last 7 years?NoYes

If yes, please list convictions that are a matter of public record (an arrest is not a conviction). A conviction will not necessarily disqualify you from employment. *

Are you of legal age to serve alcohol?YesNoI will be next month

Do you have reliable means of transportation to work?YesNoI use public transit

What position(s) are you applying for?HostServerChefLine CookDelivery DriverDishwasherOffice AssistantManagementOpen to Anything

If applying for Delivery Driver, have you been involved in a moving vehicle violation in the last 7 years? NoYes

If yes, please list

What skills do you have that are applicable to position(s) applied for?

Date available for employment

If hired, how long do you plan to be employed by BuffaLouie’s?

How many hours are you able to work per week?

Do you have any regularly scheduled or intermittent obligations that may affect your availability to work?NoYes

If yes, please list

Specify days available each day of the week

• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Saturday
• Sunday

Specify hours available each day of the week

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Education

High School Name and Address

Last year completed High School1234

Did you Graduate from High School?YesNo

Subjects studied, Degrees received

College

College Name and Address

Last year completed College1234

Did you Graduate from College?YesNo

Subjects studied, Degrees received

Post College

Name and Address of Post College School

Last year completed Post College1234

Did you Graduate from Post College?YesNo

Subjects studied, Degrees received

Name and Address of Trade School

Last year completed Trade Business School1234

Did you Graduate from the Trade School?YesNo

Subjects studied, Degrees received

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Provide information for your last 3 employers starting with the most recent. If never employed, list any volunteer activities.

Employer 1

Business Name

Supervisor Name

First

Last

Position held

Dates (From:)

Dates (To:)

Location

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone Number

Last rate of pay

Reason for leaving

Are you eligible for rehire?YesNoIt's Complicated

Employer 2

Business Name

Supervisor

First

Last

Position held

Dates (From:)

Dates (To:)

Location

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone Number

Last rate of pay

Reason for leaving

Are you eligible for rehire?YesNoIt's Complicated

Employer 3

Business Name

Supervisor Name

First

Last

Position held

Dates (From:)

Dates (To:)

Location

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone Number

Last rate of pay

Reason for leaving

Are you eligible for rehire?YesNoIt's Complicated

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Personal References

Reference 1

Name *

First

Last

Phone Number *

Occupation

Relationship

Years acquainted

Reference 2

Name *

First

Last

Phone *

Occupation

Relationship

Years acquainted

Reference 3

Name *

First

Last

Phone *

Occupation

Relationship

Years acquainted

SubmitSave and Resume Later

BuffaLouie’s provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, or genetics.