Employment Application

Which location are you applying for?

Last Name

First Name

Your Email

Phone Number

Street Address



Position you are applying for?

Where did you come across our job advertisement?

How long do you see yourself working for The Couch Tomato, if hired?

Do you have a car and your own auto insurance?

All ShiftsMon AMMon PMTue AMTue PMWed AMWed PMThur AMThur PMFri AMFri PMSat AMSat PMSun AMSun PM

Ideal amount of hours worked each week

Scheduling Conflicts? Do you currently have any other weekly scheduling commitments on a regular basis? Please explain.

Use this space to tell us about yourself or your current situation in life, if you are willing to do so:

Desired Salary/Wages

Previous Employment

Please list company, position, dates from-to, brief description of duties/title, reason for leaving.


Have you either obtained a high school diploma or GED certification?

Please upload your Resume - (PDF ONLY, If Applicable)

e-Signature (My e-Signature is confirmation that all answers given herein are true and complete)