First Name*
Middle Name
Last Name*
Address*
City*
State*
Zip*
Phone*
Email*
Position(s) you are applying for*
Type of employment you are seeking* ---Part TimeFull TimeAny
Desired length of employment*
Earliest start date if hired*
List Highest Level of Education Information* ---GEDHigh School DiplomaAssociates DegreeBachelor's DegreeMaster's DegreeSpecialty CertificateNone
Employment History Give employment record as completely as possible, starting with your present or latest employer. Include summer employment and any military service for any unemployed or self employed periods, show dates and location.
Employer #1*
Nature of Business*
Position Held*
Supervisor*
Supervisor's Title*
Supervisor's Phone*
May we contact your supervisor? YesNo
Brief description of job*
Date of Employment Start*
Date of Employment End*
Hours per week*
Last rate of pay*
Reason for leaving*
Employer #2*
Employer #3
Nature of Business
Address
City
State
Zip
Phone
Position Held
Supervisor
Supervisor's Title
Supervisor's Phone
Brief description of job
Date of Employment Start
Date of Employment End
Hours per week
Last rate of pay
Reason for leaving
References Please provide anyone who you feel would be able to provide insight as to who you are as an employee or your work ethic or various skills.
Reference #1*
Contact Number*
Contact Email Address*
Relationship to you and/or position held while working together*
Reference #2
Contact Number
Contact Email Address
Relationship to you and/or position held while working together
Reference #3
General Information
In case of emergency, notify - (Name)*
Relationship to applicant*
Do you have a valid US drivers license?*
What does "customer service" mean to you?*
What is your preferred method of receiving feedback about your work performance?*
Do you have any supervisory experience? If yes, explain*
Please use this space to provide any additional information which should be considered in evaluating qualifications for employment
Please read each statement carefully before signing
I affirm that the above information is accurate and complete to the best of my knowledge. I understand that providing false or misleading information or the omission of certain information may be cause for refusal to hire or dismissal. I authorize Bluefin Bay Management Company and its agents to obtain verification and investigate any information provided in this application including education background, employment history, and any other information that we believe may be relevant to your qualifications to work for our company. I authorize Bluefin Bay Management Company and its agents to contact former employers, educational institutions, and references for the purpose of obtaining such information. Further, I authorize past employers and agents of employers to furnish any information concerning me including that related to performance, attendance, compensation, discipline, and separation of employment. I understand that all information collected will be used for the purpose of determining my acceptability for employment.
I understand that Bluefin Bay Management Company, as a condition of hire, may conduct or use a consumer reporting agency to conduct an investigation into my criminal background, credit status, character, and other personal characteristics and information. I hereby consent to this investigation and authorize Bluefin Bay Management Company to procure consumer reports and/or investigative consumer reports on my background. In compliance with the Fair Credit Reporting Act, Bluefin Bay Management Company will provide you with written notice disclosing our intent to seek background information on you. You have the right to receive a copy of any such report that we obtain.
I agree, as a condition of hire, that Bluefin Bay Management Company may require me to answer certain medical questions and undergo a physical examination to determine my ability to perform the job for which I am applying. As a condition of hire, I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. To the best of my knowledge, I believe I will be able to meet the physical requirements for the position for which I am applying. Bluefin Bay Management Company is an Equal Opportunity Employer and will make “reasonable accommodations”, as defined by the US Department of Labor, to employ people with disabilities.
I also agree, as a condition of hire, to provide documents establishing proof of identity and employment eligibility.
I understand that if employed, my employment will be at will. I understand that I will not have a contract for employment nor a guarantee of continued employment. I understand that either Bluefin Bay Management Company or I may end employment at any time.
Applicant Signature*
Date*
