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(* Required Field)
Personal Information
Date:
*First Name:
*Last Name:
Middle Initial:
*Email:
*Street Address:
*Phone:
*City/Town:
*State:
Are you over 18 years old?
If no, hire is subject to verification of minimum legal age.
List friends and relatives working for us:
Referred by:
Employment Desired
Position(s) applied for:
Expected Pay:
Have you ever been employed by this Company?
If yes, Where?
If yes When?
Would you like:
Full-time
Part-time
Year Round
Seasonal
Which days or shifts?
If accepted, on what date will you be available for work?
What are your current obligations to National Guard or Reserves?
Which of our locations do you want to work in? Please check the appropriate box(es).
Hearth 'n Kettle, Hyannis
Hearth 'n Kettle, South Yarmouth
Hearth 'n Kettle, Orleans
Hearth 'n Kettle, Weymouth
Hearth 'n Kettle, Attleboro
The Dan'l Webster Inn
Cape Codder Resort & Spa
John Carver Inn
Pondside Gifts & Boutique
Any location
Have you ever been convicted of a felony?
If yes, give dates of conviction (“An applicant for employment with a sealed record on file with the Commissioner
of Probation may answer “no record” with respect to an inquiry herein relative to prior arrests, criminal court
appearances or convictions. In addition, any applicant for employment may answer “no record” with respect to any
inquiry relative to prior arrests, court appearances and adjudications in all cases of delinquency or as a child in
need of services which did not result in a complaint transferred to the superior court for criminal prosecution.”)
Educational Background
Type of School
Name and City
No. of Yrs. Completed
Major
High School
College
Business or Trade
References: Give below the names of two persons not related to you, whom you have known at least one year.
Name
Address & Phone
Business
Yrs. Acquainted
Prior Work History (List in order, last or present employer first)
Start Date:
End Date:
Name and Address of Company:
Starting Rate:
Finishing Rate:
Supervisor’s Name Title & Phone:
Reason for Leaving:
List positions held and describe in detail the type of work you did.
Start Date:
End Date:
Name and Address of Company:
Starting Rate:
Finishing Rate:
Supervisor’s Name Title & Phone:
Reason for Leaving:
List positions held and describe in detail the type of work you did.
Start Date:
End Date:
Name and Address of Company:
Starting Rate:
Finishing Rate:
Supervisor’s Name Title & Phone:
Reason for Leaving:
List positions held and describe in detail the type of work you did.
What Are Your Career Objectives?
May we contact the employers listed above?
If not, indicate below which one(s) you do not wish us to contact.
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice.
DECLARATION: I hereby declare by initialing below that the information provided by me on this form is true and accurate to the best of my knowledge.
Date:
*Initials:
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
