---

Position Applied for:

Last Name:

First Name:

Middle Initial:

Street Address:

Apt #:

City/Town:

State:

Zip:

Home Phone:

Work Phone:

Email

---

Person to Contact in Case of Emergency

Full Name:

Telephone #

Address:

Salary Desired

---

Please understand that an offer of employment and continued employment with Chatham Bars Inn are contingent upon satisfactory proof of authorization to work in the United States.

Have you ever been employed by Chatham Bars Inn?

 yes

 no

if yes, please specify dates:

From:

To:

How were you referred to Chatham Bars Inn?

---

If required, would you be willing to work:

Seasonal: 

---

When could you begin work?

---

Name/Location of School:

# Years Completed:

Degree/Diploma/Certificate:

Major/Minor Field of Study:

Are you fluent in a foreign language?  

yes no

 

Language 1.

 

  speak

  write

 

 

Language 2.

 

  speak

  write

 

Are you a veteran of any branch of the U.S. Armed Forces?

yes

no

If yes, please describe any skills you acquired that would be relevant to the position for which you are applying:

Licensure: License#

State:

Expiration date:

---

Please list your employment history for the past ten years (or last four employers). Start with your present status and note any periods in which you were not employed. Include U.S. military service, previous Chatham Bars Inn experience, summer/part time jobs, volunteer work and cooperative education assignments.

1. Dates Worked:

From:

To:

May employer be contacted at this time for a reference?

yes

no

Employer's Name:

Supervisor's Name and Title:

Employer's Address:

Your Job Title and Duties:

Employer's Telephone #

Reason for Leaving:

2. Dates Worked:

From:

To:

May employer be contacted at this time for a reference?

yes

no

Employer's Name:

Supervisor's Name and Title:

Employer's Address:

Your Job Title and Duties:

Employer's Telephone #

Reason for Leaving:

3. Dates Worked:

From:

To:

May employer be contacted at this time for a reference?

yes

no

Employer's Name:

Supervisor's Name and Title:

Employer's Address:

Your Job Title and Duties:

Employer's Telephone #

Reason for Leaving:

4. Dates Worked:

From:

To:

May employer be contacted at this time for a reference?

yes

no

Employer's Name:

Supervisor's Name and Title:

Employer's Address:

Your Job Title and Duties:

Employer's Telephone #

Reason for Leaving:

Please supply us with the names of three personal references who are not related to you.

Name 1:

Address 1:

Occupation 1:

Telephone 1:

Years Acquainted 1:

Name 2:

Address 2:

Occupation 2:

Telephone 2:

Years Acquainted 2:

Name 3:

Address 3:

Occupation 3:

Telephone 3:

Years Acquainted 3:

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY

• I authorize the persons, schools, current employer (if approved by me in the Employment Experience Section) and other organizations or employers named in this application to provide Chatham Bars Inn with any relevant information that may be required to arrive at an employment decision.
• I understand and agree that:
• The information that I have provided is accurate to the best of my knowledge and subject to verification by Chatham Bars Inn.
• A material misrepresentation or deliberate omission of a fact in my application may be justification for refusal of employment or, if employed, termination by Chatham Bars Inn.
• Although management makes every effort to accommodate individual preferences, business needs at times make the following conditions mandatory; overtime, shift work, a rotating work schedule other than Monday through Friday. I understand and accept these conditions of my continuing employment.
• Chatham Bars Inn employees are at-will employees, who are not employed for any length of time. They may be separated or voluntarily leave their employment at any time.
• I understand that nothing contain in this employment application or in the granting of an interview is intended to create an employment contract between myself and Chatham Bars Inn for either employment or for the providing ofany benefit. No promise regarding continued employment has been made to me, and I understand that no such promise or guarantee is binding upon Chatham Bars Inn unless made in writing.