All information is kept private and used for employment opportunities within Historian Inn only.
    All areas must be filled out unless otherwise noted for consideration

    Date

    Your Name
    Last First Middle Maiden

    Your Email

    Present Physical Address

    City State Zip

    Mailing Address (if different)

    City State Zip

    How Long at Present Address?

    Social Security No. --

    Telephone (include area code)
    I II if under 18, please list age

    (Be Specific):
    Position applied for (1) and salary desired
    Position applied for (2) and salary desired

    Days/hours available to work
    No PrefMonTuesWedThursFriSatSun
    How many hours can you work weekly?
    Can you work nights? YesNo

    Employment Desired Full-Time OnlyPart-Time OnlyFull or Part-Time
    When are you available for work?

    Have you ever been convicted of a felony? YesNo
    If yes, please explain:

    Do you have a driver's license? YesNo
    If Yes, what is your driver's license number? State
    What is your means of transportation to work?

    REFERENCES Please list two references other than relatives or previous employers
    Reference #1
    Name
    Position
    Company
    Address City State Zip
    Email
    Telephone

    Reference #2
    Name
    Position
    Company
    Address City State Zip
    Email
    Telephone

    Please use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying:

    MILITARY Have you ever been in the armed forces? YesNo
    Are you now a member of the national guard? YesNo
    Specialty Date Entered Discharge Date

    EDUCATION
    1st box: Enter Number of Years Completed | 2nd box: Enter School, Major and Degree
    High School
    College
    Bus. or Trade School
    Professional School

    WORK EXPERIENCE
    (You may skip this if clearly outlined on resume. File size limit 5MB.)
    ATTACH YOUR RESUME HERE:
    ATTACH YOUR COVER LETTER HERE:

    Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

    Work Experience #1
    Name of Employer: Address/Town
    Name of Last Supervisor: Employment Dates: Pay or Salary:
    Telephone: Email:
    Your last job title:
    Reason for leaving (be specific):
    List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

    Work Experience #2
    Name of Employer: Address/Town
    Name of Last Supervisor: Employment Dates: Pay or Salary:
    Telephone: Email:
    Your last job title:
    Reason for leaving (be specific):
    List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

    Work Experience #3
    Name of Employer: Address/Town
    Name of Last Supervisor: Employment Dates: Pay or Salary:
    Telephone: Email:
    Your last job title:
    Reason for leaving (be specific):
    List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company:

    May we contact your present employer? YesNo
    Did you complete this application yourself? YesNo

    AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)
    I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.

    I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with Historian Inn creates an actual or implied contract of employment. I understand that, if I accept employment with Historian Inn, it will be on an at-will basis. This means that either Historian Inn or I have the right to terminate the employment relationship at any time, for any reason, with or without cause.

    I agree to submit to drug and alcohol testing, if requested by Historian Inn. I release Historian Inn, and its employees, plus other persons or companies, from any and all liability arising out of or related in any way to such testing.

    I authorize Historian Inn to investigate information concerning my education, employment experiences and all other aspects of my background relevant to my proposed employment. I release Historian Inn and its employees from all liability arising from such investigation.

    I AGREE: Date:

    Historian Inn is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with Historian Inn depends solely on your qualifications.