Appleton Microtel Inn & Suites

Date*

The following information is requested in order to help us make a possible placement within the Company. All portions of this application pertaining to you must be completed. We appreciate the time you spend in filling in this application form. The Company, in accordance with State and Federal laws, does not discriminate on the basis of age, race, religion, color, sex, national origin, marital status, physical or mental disability or arrest record.

Position for which you would like to be considered

Name*

FirstLast

Present Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Phone*

Are you employed now?*

Yes
No

If yes, may we contact your present employer?*

Yes
No

On what date would you be able for work?*

Type of work*

Full-time
Part-time
Temporary

Are you 18 years of age or older?*

Yes
No

(If not, employment is subject to verification of minimum legal age.)

Have you ever been convicted of a crime in the last ten (10) years?*

Yes
No

Criminal convictions are not an absolute ban to employment but will only be used in relation to specific job requirements.

If yes, please describe*

Have you ever been employed at this company before?*

Yes
No

Are you legally eligible for employment in this country?*

Yes
No

(Proof of U.S. Citizenship or immigration status will be required upon employment.)

How were you referred to the Company/Motel?*

If "Other", please describe*

Education

Below, please fill out your education details. For any fields that do not apply, please enter N/A.

High School

High School Name*

Location*

Degree*

Subject Area*

College

College Name*

Location*

Degree*

Subject Area*

Trade, business or correspondence school

Trade, business or correspondence school name*

Location*

Degree*

Subject Area*

Employment History

(Past work experience - beginning with current/most recent employer)

Employer 1

Employer Name*

Employer Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Job Title*

Supervisor's Name*

FirstLast

Supervisor's Phone Number

Reason for leaving*

Enter "Still currently employed" if you are still employed by this company.

Start Date*

Date Ended

(Leave blank if still employed with this company.)

Starting Wage*

Ending Wage*

Work Performed*

May we contact them?*

Yes
No

Employer 2

Employer Name*

Employer Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Job Title*

Supervisor's Name*

FirstLast

Supervisor's Phone Number*

Reason for leaving*

Enter "Still currently employed" if you are still employed by this company.

Start Date*

Date Ended

(Leave blank if still employed with this company.)

Starting Wage*

Ending Wage*

Work Performed*

May we contact them?*

Yes
No

Employer 3

Employer Name*

Employer Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Job Title*

Supervisor's Name*

FirstLast

Supervisor's Phone Number*

Reason For Leaving*

Enter "Still currently employed" if you are still employed by this company.

Start Date*

Date Ended*

(Leave blank if still employed with this company.)

Starting Wage*

Ending Wage*

Work Performed*

May we contact them?*

Yes
No

References

(Give the name of the thee persons not related to you, whom you have known at least one year.)

Reference 1

Name*

FirstLast

Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Business*

Phone

Reference 2

Name*

FirstLast

Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Business*

Phone

Reference 3

Name*

FirstLast

Address*

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Business*

Phone*

AGREEMENT

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) would result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

I understand that nothing contained in the application or discussed during an interview, if granted, creates or is intended to create an employment contract between the Company and me.

In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either the Company or me.

I authorize and release from liability all employers, persons, schools, law enforcement agencies, and other organizations named in this application to provide information requested.

I understand that no manager, or representative of the Company, other than the chief operating officer of the Company, has any authority to enter into agreement for employment for any specified period of time or make any agreement contrary to the information stated in this application.

I agree to conform to the rules and regulations of the Company, and understand that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time at the option of either the Company or me.

Name*

FirstLast

Email*

Submit Date*

Authorization*

Yes, I agree

By entering your name, date, ticking this agreement check box and clicking the Submit Application button you, the applicant, agree with all statements listed in the AGREEMENT section of this form.

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