Patoka 4 Seasons Resort Application for Employment
7886 W SR 164, Eckerty, IN 47116
Info@patoka.com
Questions? 812-685-2488
Name
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First Name
Middle Initial
Last Name
Application Date:
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Month
-
Day
Year
Date
Date of Birth:
*
-
Month
-
Day
Year
Date
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone:
*
Email:
*
example@example.com
Do you have a valid driver's license?
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Yes
No
Do you have reliable transportation?
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Yes
No
Have you ever worked for this company before?
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Yes
No
If yes, When?
Are you legally allowed to work in the United States?
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Yes
No
Position Applying for:
Title:
*
Employment Type
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Full Time
Part Time
Desired Salary:
*
Referred by:
Date Available:
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Month
-
Day
Year
Date
Can you work weekends and Holidays?
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Yes
No
How many Hours per week could you work?
*
Do you have travel plans between May 1 and September 5? If so, please explain and list dates:
Education:
Rows
School Name
Location
Years Attended
Degree Received
Major
1
2
3
Summarize any special skills or qualifications (computer skills, mechanical skills, etc.)
*
Active Military Status National Guard or Reserve:
*
YES
NO
Rank at Discharge:
Type of Discharge:
Back
Next
Employment:
Rows
Employer
Supervisor
Phone Number
Dates Employed
City
State
Position
Pay Rate
Duties Performed
Reason For Leaving
May We Contact?
1
2
3
References:
Give names and phone numbers of three persons not related to you, whom you have known for at least one year.
Name:
*
First Name
Last Name
Phone Number:
*
Affiliation:
*
Name:
*
First Name
Last Name
Phone Number:
*
Affiliation:
*
Name:
*
First Name
Last Name
Phone Number:
*
Affiliation:
*
Record of Conviction:
During the last 10 years, have you ever been convicted of a crime other than minor traffic offenses?
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Yes
No
If yes, explain:
(A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness, and nature of the crime, and rehabilitation will be considered).
Acknowledgement and Authorization:
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I certify that all 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) may result in discharge.
In consideration of my employment, I agree to adhere to all existing & future instructions, rules & policies.
Signature
*
Date:
*
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Month
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Day
Year
Date
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