Thank you for your interest in employment with the WB. Please fill in the form below to apply for employment with us.

NOTE: Our organization does not discriminate on the basis of race, color, religion, national origin, sex, marital status, sexual orientations, and/or status with regard to public assistance, disability, age, or any other protected classification. Windbreak Saloon provides reasonable accommodations to qualified applicants and employees with disabilities.

Submit Your Application

Fields marked (*) are required.

Personal Information
First name *
Middle initial *
Last name *
Address *
City *
State *
ZIP code *
Email *
Phone (with area code) *
Secondary/other phone (with area code)
Preferred method of contact Email     Phone    
Emergency contact and phone number (with area code)
Date of birth (mm/dd/yyyy)
Are you legally eligible for employment in the United States? * Yes     No    
Have you ever been convicted of any offenses or completed a period of incarceration within the past ten years? * Yes     No    
If yes, please explain
Have you ever been employed by The Windbreak? * Yes     No    
If you were employed for this company, during what time did this occur?
Were you referred to us? Yes     No    
If yes, please enter the referrer’s name
List any friends/relatives currently employed by The Windbreak
General Information
Position for which you are applying *
Date you can start working *
Salary/wage you are seeking *
Which work schedule are you willing to accept? * Full-time     Part-time     Temporary    
Days you are available to work Monday
Education and Training
What is the highest level of education you have completed? * GED     High school     College     Graduate school    
Name of high school
What is the highest grade level you completed in high school? 9     10     11     12    
Name of college
Work History
Have you ever been employed before? * Yes     No    
Are you currently employed? * Yes     No    
If you are currently employed, may we contact your employer? Yes     No    
Name of current/most recent employer
City of current/most recent employer
Address of current/most recent employer
State of current/most recent employer
ZIP code of current/most recent employer
Phone (with area code) of current/most recent employer
Job title for current/most recent employer
Hours worked per week for current/most recent employer
What specific tasks did you complete for this job?
What machines/equipment did you operate for this job?
Date started for this employer
Date ended for this employer
Wage (per hour or pay period) for this job
Reason for leaving this job
Supervisor for current/most recent employer
How many other previous employers have you had? * None     One     Two     More than two    
Please summarize any other work history you have
First name of reference 01 *
Last name of reference 01 *
Address of reference 01 *
City of reference 01 *
State of reference 01 *
ZIP code of reference 01 *
Phone (with area code) of reference 01. *
First name of reference 02 *
Last name of reference 02 *
Address of reference 02 *
City of reference 02 *
State of reference 02 *
ZIP code of reference 02 *
Phone (with area code) of reference 02 *
First name of reference 03 *
Last name of reference 03 *
Address of reference 03 *
City of reference 03 *
State of reference 03 *
ZIP code for reference 03 *
Phone (with area code) for reference 03 *
Additional Comments
Additional comments

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

I also authorize The Windbreak to make any investigation of my personal or employment history, and I also authorize any former employer, person, firm, corporation, or government agency to give The Windbreak any information they may have pertaining to me. In consideration of The Windbreak’s review of this application, I release The Windbreak and all providers of information from any liability as a result of furnishing and receiving this information.

Agreement Acknowlegment
Do you agree with the above statements? * Yes, I do