Employment Application

First Name:*

Last Name:*

Middle Name:

If any of your educational or employment records are under any name(s) other than that shown above, please provide the name(s) under which these records may be located:

Address (line 2):

City:*

State/Province:*---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon TerritoryOther

Zip Code:*

Home Phone:*
Format: 123-456-7890

Cell Phone:
Format: 123-456-7890

eMail:*

Position Applying For:

Are you at least 18 years of age or older?---YesNo

How did you learn about this employment opportunity?

Are you available for overtime?---YesNo

Have you previously applied for employment with Hotel Fifty?---YesNo

Employment Status Desired (Check all that apply): Full-Time Part-Time Temporary

Are you employed now?---YesNo

If so, Date available (MM/DD/YYYY)

Salary/Wages Desired

Are you legally authorized to work in the country to which you are applying? (Candidates for employment in the United States, in compliance with federal law, will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire).---YesNo

SINCE YOUR 18TH BIRTHDAY HAVE YOU EVER BEEN CONVICTED OR PLED GUILTY TO ANY FELONY OR MISDEMEANOR OTHER THAN A MINOR TRAFFIC VIOLATION?

When completing this section, do not disclose information regarding convictions that have been judicially sealed, expunged, eradicated, impounded or dismissed. Do not disclose information regarding juvenile court convictions or minor traffic violations. A conviction record does not automatically bar you from employment. All of the job-related circumstances surrounding convictions will be considered.

1. FELONY:
2. MISDEMEANOR:
3. ARE THERE CURRENTLY CHARGES PENDING?
4. ARE YOU CURRENTLY ON PROBATION?
5. IF YOU ANSWERED YES TO ANY OF THE QUESTIONS ABOVE, PLEASE EXPLAIN BELOW

---YesNo

Explanation of Convictions (if applicable):

Company Name

Telephone:
Format: 123-456-7890

Type of Business

City:

State/Province:---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon TerritoryOther

Other State/Province:

Zip Code:

May We Contact?---YesNo

Start $

Last $

Other Compensation (Shift Premium, Bonus):

Name and Title of Immediate Supervisor:

Date Hired (MM/DD/YYYY)

Date Separated (MM/DD/YYYY)

Reason for Leaving:

State Current/Last Job Title and Describe Your Work:

Company Name

Telephone:
Format: 123-456-7890

Type of Business

City:

State/Province:---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon TerritoryOther

Other State/Province:

Zip Code:

May We Contact?---YesNo

Start $

Last $

Other Compensation (Shift Premium, Bonus):

Name and Title of Immediate Supervisor:

Date Hired (MM/DD/YYYY)

Date Separated (MM/DD/YYYY)

Reason for Leaving:

State Current/Last Job Title and Describe Your Work:

Company Name

Telephone:
Format: 123-456-7890

Type of Business

City:

State/Province:---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon TerritoryOther

Other State/Province:

Zip Code:

May We Contact?---YesNo

Start $

Last $

Other Compensation (Shift Premium, Bonus):

Name and Title of Immediate Supervisor:

Date Hired (MM/DD/YYYY)

Date Separated (MM/DD/YYYY)

Reason for Leaving:

State Current/Last Job Title and Describe Your Work:

Training in Specialty Areas:

Describe any other education, training, skills, language proficiencies, or certificates you possess which are relevant to the position for which you have applied:

Do you hold professional licensure/certification?---YesNo

List all methods, techniques, equipment and computer software applications with which you are proficient and which are relevant to the job for which you have applied:

List current and former co-workers, colleagues and/or professional acquaintances not related to you (other than those persons listed previously) who can provide first-hand knowledge of your qualifications and abilities. Hotel Fifty may contact these references in connection with its consideration of your credentials.