APPLICATION FOR EMPLOYMENT PRE-EMPLOYMENT QUESTIONNAIRE EQUAL OPPORTUNITY EMPLOYER

____________________________________ ____________________________________ ________________________________________ ________________________________________ (For office Use Only)

INSTRUCTIONS: Please fill out the application completely even if you attach a resume.

PERSONAL INFORMATION

NAME (LAST, FIRST, MIDDLE INITIAL)		DATE
PRESENT ADDRESS	CITY	STATE	ZIP CODE
PHONE NUMBERDAY ( ) EVENING ( )	EMAIL ADDRESS	REFERRED BY

POSITION APPLYING FOR	DATE YOU CAN START	SALARY DESIRED
ARE YOU CURRENTLY EMPLOYED? YES IF YES, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? YES NO NO
HAVE YOU EVER APPLIED YES IF YES, WHEN?TO THIS COMPANY BEFORE? NO	HAVE YOU EVER WORKED YES IF YES, WHEN?FOR THIS COMPANY BEFORE? NO

AVAILABILITY FOR WORK

TYPE OF WORK FULL TIME PART TIME TEMPORARY	SHIFT DESIRED DAY WILLING TO WORK ANYSWING
WILL YOU WORK OVERTIME DURING YESTHE WORK WEEK IF NECESSARY? NO	WILL YOU WORK WEEK-END YESOVERTIME IF NECESSARY? NO
DO YOU HAVE ANY ON-GOING OBLIGATIONS OR OTHER PERSONAL COMMITMENTS THAT WOULD AFFECT YOUR WORK SCHEDULE? YES NO IF YES, PLEASE DESCRIBE:

PERSONAL

IF REQUESTED, WOULD YOU BE WILLING TO TAKE A DRUG/ALCOHOL SCREENING EXAM AS A CONDITION OF EMPLOYMENT? YES NO

ARE YOU AT LEAST 18 YEARS OLD? YES NO

CAN YOU PROVIDE DOCUMENTED PROOF OF U.S. CITIZENSHIP OR, IF AN ALIEN, PROOF OF AUTHORIZATION TO WORK IN THE UNITED STATES? YES NO

HAVE YOU EVER BEEN DISCIPLINED OR TERMINATED? YES NO IF YES, PLEASE EXPLAIN:

HAVE YOU EVER BEEN CONVICTED OF ANY LAW VIOLATION, EXCEPT A MINOR TRAFFIC VIOLATION? YES NO(A CRIMINAL RECORD DOES NOT AUTOMATICALLY BAR EMPLOYMENT) IF YES, PROVIDE DETAILS:

EDUCATION AND TRAINING

	SCHOOL NAME CITY AND STATE	# YEARS ATTENDED	DID YOU GRADUATE?	MAJOR SUBJECTS, SPECIAL COURSES DEGREES
HIGH SCHOOL
COLLEGE OR UNIVERSITY
GRADUATE SCHOOL
OTHER EDUCATION
LICENSES AND CERTIFICATIONS
OTHER SKILLS

EMPLOYMENT RECORD: DO NOT indicate “see resume“.

Give a complete account of your employment, including salary history. Begin on the first line with your present or most recent position and work back. Please attach an additional sheet if necessary and include all periods of unemployment.

MONTH/YRSTARTED	NAME, ADDRESS, PHONE OF EMPLOYER	STARTING SALARY	POSITION/DUTIES	REASON FOR LEAVING
MONTH/YRENDED		ENDING SALARY		SUPERVISOR’S NAME & TITLE
WHAT DID YOU LIKE ABOUT THIS JOB?		WHAT DID YOU DISLIKE ABOUT THIS JOB?
MONTH/YRSTARTED	NAME, ADDRESS, PHONE OF EMPLOYER	STARTING SALARY	POSITION/DUTIES	REASON FOR LEAVING
MONTH/YRENDED		ENDING SALARY		SUPERVISOR’S NAME & TITLE
WHAT DID YOU LIKE ABOUT THIS JOB?		WHAT DID YOU DISLIKE ABOUT THIS JOB?
MONTH/YRSTARTED	NAME, ADDRESS, PHONE OF EMPLOYER	STARTING SALARY	POSITION/DUTIES	REASON FOR LEAVING
MONTH/YRENDED		ENDING SALARY		SUPERVISOR’S NAME & TITLE
WHAT DID YOU LIKE ABOUT THIS JOB?		WHAT DID YOU DISLIKE ABOUT THIS JOB?
MONTH/YRSTARTED	NAME, ADDRESS, PHONE OF EMPLOYER	STARTING SALARY	POSITION/DUTIES	REASON FOR LEAVING
MONTH/YRENDED		ENDING SALARY		SUPERVISOR’S NAME & TITLE
WHAT DID YOU LIKE ABOUT THIS JOB?		WHAT DID YOU DISLIKE ABOUT THIS JOB?

WORK REFERENCES: Please provide a minimum of three.

FIRST NAME, LAST NAME	COMPANY & TITLE	RELATIONSHIP TO YOU	TELEPHONE NUMBER

PERSONAL REFERENCES: Please provide a minimum of two people who are not related to you.

FIRST NAME, LAST NAME	COMPANY & TITLE	RELATIONSHIP TO YOU	TELEPHONE NUMBER

CERTIFICATE OF APPLICANT (Read carefully before signing.)

All information provided by me is true and correct to the best of my knowledge. I understand omissions or misrepresentations may result in rejection of my application or if employed, may result in subsequent dismissal. I hereby authorize all former employers, educational institutions, personal references and others identified hereon, including their employees or representatives, to furnish or provide full and complete reports, documents or information to Sequoyah Marina or its representative concerning my prior educational and work histories, criminal and driving records, or other information I have provided hereon. I waive, release, indemnify and hold harmless Sequoyah Marina, its subsidiaries or affiliate companies, employees and representatives and all other persons or entities from all liability and all claims of any nature whatsoever pertaining to the disclosure or use of information or written material as described above. I understand this is a preliminary application and not a contract to employ me. Furthermore, in the event I am employed, my employment shall be completely voluntary and may be terminated at will at any time by either myself or the company. I understand that any employment agreement to the contrary must be in writing and approved by the Company’s Chief Operating Officer or President. If employed, I agree to comply with all rules of the company as a condition of continued employment.

DATE __________________________                                          SIGNATURE OF APPLICANT _________________________________________