Social Security Number:
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Job(s) Applied For:
Referral Source:Select:AdvertisementFriendRelativeWalk-inEmployment AgencyOther
Have you worked for us before?Select:NoYes
If yes, when/where?
If hired, on what date will you be available to start work?
Are there any experiences, skill, qualifications or licenses you feel make you especially fit for work with The Inn?
Are you authorized for employment in the U.S.?Select:NoYes
Have you ever pled guilty to a crime?Select:NoYes
If yes, please explain (including nature of the offense, date of conviction or guilty plea, penalty imposed, and other relevant circumstances)
Have you ever been the subject of disciplinary action by a prior employer?Select:NoYes
If yes, describe the nature of that action:
Grammar/Grade School Name:
Course or Major:
High School Name:
Other Education Source Name:
List your previous jobs in chronological order, starting with the most recent:
Name of Employer and Supervisor:
Full Address and Phone Number:
End Date (Leave blank if current job):
Reason for Leaving:
Name and Relationship:
My employment is at-will. My employment is not guaranteed for any term, and may be terminated by The Inn or myself at any time for any reason. No representative of The Inn, including any manager, is authorized to make any oral or written assurance or promise of continued employment.
All information (including information on any accompanying resume) is subject to verification. The Inn may require me to submit to drug/alcohol testing after receiving a conditional offer of employment and I must pass that test prior to assuming or continuing any job duties. I understand and agree to comply with this condition of employment.
My employment is conditioned upon the results of a reference check. I authorize you to contact former employers and references.
Any misrepresentation or falsification of information or omission will be cause for rejection of any application or for immediate dismissal.
401 West College Avenue | Ada, Ohio 45810 Phone: (419) 772-2500 Toll Free: (866) 713-4513