Settle Inn Employment Application

Employment Application

Programs, services and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accommodation for the application or interview.

* Required

Position applying for:
Applicant Data
How were you referred to us?
Full Name First Middle Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Phone - (###) - ### ####
Mobile/Pager/Other - (###) - ### ####
Email
Date Available to Start / MM / DD YYYY
Social Security Number:
Salary Requirements:
If you are under 18 years of age, can you provide a work permit?
Yes No
If no, please explain:
Have you ever worked for this company?
Yes No
If yes, when?
Are you legally allowed to work in the United States?
Yes No
Type of employment desired:
Full-Time Part-Time Temporary Seasonal
Have you ever plead guilty, no contest or been convicted of a crime?
Yes No

Answering yes to this question does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.
If yes, give dates and details:
Driver’s license number (if applicable to position):
State
Education
College/Technical School Attended:
Graduated?
Yes No
Major:
Previous Employment

Begin with most recent
#1
Dates of Employment
From: / MM / DD YYYY
To: / MM / DD YYYY
Position(s) Held:
Company Name:
Address
Street Address Address Line 2 City State / Province / Region
Phone - (###) - ### ####
Supervisor:
Responsibilities:
Starting Salary and Title:
Exiting Salary and Title:
Reason for leaving:
May we contact this employer for a reference?
Yes No
#2
Dates of Employment
From: / MM / DD YYYY
To: / MM / DD YYYY
Position(s) Held:
Company Name:
Address
Street Address Address Line 2 City State / Province / Region
Phone - (###) - ### ####
Supervisor:
Responsibilities:
Starting Salary and Title:
Exiting Salary and Title:
Reason for leaving:
May we contact this employer for a reference?
Yes No
#3
Dates of Employment
From: / MM / DD YYYY
To: / MM / DD YYYY
Position(s) Held:
Company Name:
Address
Street Address Address Line 2 City State / Province / Region
Phone - (###) - ### ####
Supervisor:
Responsibilities:
Starting Salary and Title:
Exiting Salary and Title:
Reason for leaving:
May we contact this employer for a reference?
Yes No
Disclaimer

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations of my personal employment, educational, financial and other related matters as may be necessary for an employment decision. I herby release employers, schools or individuals from all liability when responding to inquiries in connection with my application.
In the event that I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge. *
Do Not Fill This Out

Employment Application

Applicant Data

Education

Previous Employment

#1

#2

#3

Disclaimer