Today's Date*:

Position applying for*:

2nd Choice:

Personal Information

First Name*:

Middle Name:

Last Name*:

Address:*

City:*

State:*

Zip Code:*

Phone Number:*

Alternative Phone Number:

Email Address*:

Have you ever worked for The Jefferson?*

When:

Which Department:

Please list any relatives working at The Jefferson:

Have you ever been convicted of a felony?*

Have you ever been convicted of a misdemeanor?*

If yes, please list all convictions and provide dates and court information:

The existence of a criminal record does not constitute an automatic bar to employment. However, failure to be completely honest about such records will be considered fraud and grounds for immediate dismissal.

Have you ever been fired or asked to resign from a job?*

If yes, please explain and give dates:

A firing or forced resignation does not automatically mean you cannot be employed. The circumstances, time elapsed, and recent employment record will be considered. However, failure to be completely honest and accurate about such circumstances may cause your employment application to be disqualified for employment.

Education History

High School:*

Highest Grade Completed:*

Do you have an equivalency diploma (GED)?

College Name:

Degree Completed:

Type of Degree:

Major & Minor Studies:

Other College:

Degree Completed:

Type of Degree:

Major & Minor Studies:

Other (Technical, Vocational, Military, Secretarial, etc.):

Degree Completed:

Type of Degree:

Major & Minor Studies:

Please list professional memberships, certificates, licenses, honors, fellowships, etc:

Referral Source

The following information will help us to learn the most effective way of informing interested persons of the job opportunities with The Jefferson Hotel. Please check one of the following as to how you learned of employment opportunities with The Jefferson.*

Jefferson Employee

Employee Name:

Website

Job Board

Name of Job Board:

Local Newspaper

Name of Newspaper:

Out of Town Newspaper

Name of Newspaper:

References

Please list two persons (other than relatives or former employers) who know your qualifications or who know your character.

Reference 1

Name:

Address:

City, State, Zip:

Daytime Phone:

Reference 2

Name:

Address:

City, State, Zip:

Daytime Phone:

Attach Resume:

Upload Resume (.pdf, .doc or .docx)

No resume will be accepted unless accompanied by a fully completed application

Work History

Please give a complete record of your employment history, including any part-time work, military experience, and volunteer experience. List all experience in order, starting with your present or most recent position and working back from there. Describe your duties and responsibilities in each position thoroughly so that your experience may be fully evaluated. Account for all periods of unemployment.

Employer 1

Start Dates of Employment (MO/YR):

End Dates of Employment (MO/YR):

Full-time
Part-time

If part-time, hours per week:

Employer Name:

Address:

Phone Number:

Your Job Title:

Position Duties:

Machines & Equipment used:

Supervisor Name & Title:

Reason for Leaving:

Starting Pay:

End Pay:

Your name when employed if different than present:

Number & titles of people you supervised:

Employer 2

Start Dates of Employment (MO/YR):

End Dates of Employment (MO/YR):

Full-time
Part-time

If part-time, hours per week:

Employer Name:

Address:

Phone Number:

Your Job Title:

Position Duties:

Machines & Equipment used:

Supervisor Name & Title:

Reason for Leaving:

Starting Pay:

End Pay:

Your name when employed if different than present:

Number & titles of people you supervised:

Employer 3

Start Dates of Employment (MO/YR):

End Dates of Employment (MO/YR):

Full-time
Part-time

If part-time, hours per week:

Employer Name:

Address:

Phone Number:

Your Job Title:

Position Duties:

Machines & Equipment used:

Supervisor Name & Title:

Reason for Leaving:

Starting Pay:

End Pay:

Your name when employed if different than present:

Number & titles of people you supervised:

Use the space below for any special qualifications and skills (i.e. skills with construction or office equipment, publications, etc.) or additional information that you feel will help us to evaluate your application:

May we contact your former employers?

May we contact your present employer?

If no, when?

The statements made by me on this application are true and complete to the best of my knowledge. I understand that any willful misstatements or material omissions on this application will be considered sufficient cause to disqualify me from employment with The Jefferson Hotel. If such statements or omissions are found after employment, it will be considered grounds for dismissal. I authorize the release of any job-related information that The Jefferson Hotel may request from the above sources.

Date*

Signature*

Careers Application

Reference 1

Reference 2

Employer 1

Employer 2

Employer 3