Step 1 of 2 50% EMPLOYMENT APPLICATION Please print clearly. Answer all questions.Name First Middle Last Email PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Position applying for Total hours requested per week Wage requirement Location applying at Holiday Inn Eau Claire South Holiday Inn Express Eau Claire West Holiday Inn Express Hallie Holiday Inn Express Rice Lake Candlewood Suites Larson Management Staybridge Suites Johnny's Italian Steakhouse Have you worked for us in the past? Yes No When? Where? Were you referred by a current employee? Yes No Who? Hours AvailableCheck all that apply.Sunday Morning Noon Evening Night Monday Morning Noon Evening Night Tuesday Morning Noon Evening Night Wednesday Morning Noon Evening Night Thursday Morning Noon Evening Night Friday Morning Noon Evening Night Saturday Morning Noon Evening Night When could you start work? General InformationAre you 18 years of age or older? Yes No Can you furnish a work permit? Yes No Do you have a legal right to work in the U.S.? Yes No Education/QualificationsSchool #1 Location Diploma, Degree, Licenses, Training, Etc. School #2 Location Diploma, Degree, Licenses, Training, Etc. Employment HistoryBegin with the most recent or present employer. Include military, self employment, etc.Company #1 Employed from (month & year) Employed to (month & year) Job title (describe your work)Reason for leavingCompany #2 Employed from (month & year) Employed to (month & year) Job title (describe your work)Reason for leavingCompany #3 Employed from (month & year) Employed to (month & year) Job title (describe your work)Reason for leavingReferencesList three non relatives you have worked with and whom we may contact for a work reference.Name PhoneRelationship Name PhoneRelationship Name PhoneRelationship Resume UploadMax. file size: 50 MB.Please Read Before Signing I hereby certify that the answers given by me to the above questions and statements are true and correct and hereby authorize you to contact references, past or present employers, persons, schools and any other sources of information which may be relevant to my application for employment. It is understood and agreed that any misrepresentation, false statement, or omissions by me in this application will be sufficient reason for rejection of my application or for dismissal at any time during my employment, without liability to the company. I further understand that no representative of the company has the authority to enter into any agreement for employment for any specified period of time and that the company is not guaranteeing employment for anyone. No employment contract is created by virtue of my being hired by the company. I understand that this application will remain on file for the legally required time period for consideration. After that time, if I am still interested in a position with the company, it will be necessary for me to complete a new application form.Electronic Signature Date MM slash DD slash YYYY We are an equal opportunity employer and fully subscribe to the principles of Equal Employment Opportunity. It is our policy to provide employment, compensation and other benefits related to employment based on qualifications, without regard to race, color, creed, ancestry, national origin, age, disability, gender, arrest or conviction record, marital status, religion, pregnancy, genetic info, sexual orientation, veteran status, or any other basis prohibited by federal or state law. As an equal opportunity employer, we intend to comply fully with all federal and state laws and the information requested on this application will not be used for any purpose prohibited by law. Disabled applicants may request any needed accommodation.
