Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
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Phone
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(###)
###
####
Social Security Number
Position Applying for
Are you 18 years of age or older?
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Are you currently employed?
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When are you available to start?
Are you a U.S. Citizen or authorized to work in the U.S.?
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Have you been convicted of a felony in the last 7 years?
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If yes, please provide an explanation.
Please list the name and location of your high school. Please indicate years completed and if a diploma or degree was received.
Please list the name and location of any college(s) you attended. Please indicate area of study, years completed and if a diploma or degree was received.
Summarize your job-related skills and qualifications acquired from previous employment or other experiences.
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Employment Record: Please list your most recent employer. Include address, dates employed, starting salary, final salary, reason for leaving, job title, supervisor's name and work performed.
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May we contact this employer?
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Employment Record: Please list your previous employer. Include address, dates employed, starting salary, final salary, reason for leaving, job title, supervisor's name and work performed.
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May we contact this employer?
I certify that all the information in this application is true and complete. I authorize Black Antler, Inc. (The White Horse Inn) to investigate all statements in my application, including records of any former employers, doctors, hospitals, police departments, credit agencies and other services concerning me, and authorize such sources to release such informaion without liability. I waive any written notice of the release of such records as may be required by a state or federal law. I AGREE THAT ANY EMPLOYMENT RELATIONSHIP WITH FISH TRAP, INC. WILL BE ON AN AT-WILL BASIS, WHICH MEANS THAT I MAY RESIGN AT ANY TIME OR FISH TRAP, INC. MAY DISCHARGE ME AT ANY TIME, WITH OR WITHOUT CAUSE OR NOTICE. THIS AT-WILL EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED UNLESS IN WRITING AND SIGNED BY THE PRESIDENT OF FISH TRAP, INC.
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Digital Signature
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First Name
Last Name
