Salem Cross Inn

Position you are applying for

Today's Date*

Name*

First Last

Address*

Street Address City State ZIP Code

Date of Birth*

Phone*

Email*

What is the best time to reach you?

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Are you under 18?*

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No

If under 18, can you provide required proof of your eligibility to work?*

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Have you ever applied with us before?

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Please provide the date

Have you ever been employed with us before?*

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Please provide the date*

Do you have any friends or relatives, other than spouse, that work here?

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Name, relationship and location of that person

Are you currently employed?*

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May we contact your present employer?*

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Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof of citizenship or immigration status will be required upon employment)*

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What days are you available to work?*

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Tuesday
Wednesday
Thursday
Friday
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Work availability*

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Availability Details

If you are available full time, please indicate which shift. If you are available part time please indicate the time of day. If you are looking for temporary work please indicate the dates you are available.

What is your desired salary range?

Do you have reliable transportation?*

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Education

Your HIGH SCHOOL*

Did you graduate?*

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Your UNDERGRADUATE COLLEGE

Course of study

Number of years completed

Diploma/Degree

OTHER EDUCATION

Please provide any details of additional education here including degrees/diplomas, field of study, etc.

State any additional information you feel may be helpful to us in considering your application, including any job related training in the U.S. Military

Employment Experience

Start with current or most recent.

Employer #1*

Job Title*

City, State*

Phone*

Dates Employed*

Reason for Leaving

Employer #2

Job Title

City, State

Phone

Dates Employed

Reason for Leaving

Employer #3

Job Title

City, State

Phone

Dates Employed

Reason for Leaving

Personal Information

Have you ever been convicted of a crime?*

Yes
No

If yes, what crime and where?*

Marital Status

Number of Dependents (for tax purposes)

In Case of Emergency, please notify:*

Relationship

Phone*

Address

Character References

Former Employers, no relatives please.

Name*

Phone*

Name*

Phone*

Name*

Phone*

Acceptance

By submitting this application form electronically, I certify that the answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

This application for employment shall be considered active for a period of time not to exceed 45 days.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the Employer.

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Employment Application

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Acceptance

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