Ages 16 to 20 Alcohol & Tobacco Shoppers Job Application

New York & Pennsylvania

Name:	Male or Female
Date of Birth:
Home Address :
City: State: Zip:
School(s) attended/degree(s) earned:
Graduation Date
Home Phone Number:	Your Cell Number:
Your E-mail Address:	If 16 or 17, do you have working papers? Yes No
Valid NYS Drivers License? Yes No	Or a Learner's Permit Yes No
Do You Have a Vehicle? Yes No	How old do people usually think you look?
Do You Have a laptop? Yes No	Do You Have a printer? Yes No
Height Weight Hair Color Eye Color
Schedule: Time Available to Work MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY
What Interested You in This Position?
If under 18 have you talked to your parents about this application? Yes No