Please select a locationSelect a LocationWestport VillageCommissary / KitchenPersonal InformationName*LastFirstMiddle InitialAddress* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address Home Phone*Cell PhoneDate of Birth (if under 18) MM slash DD slash YYYY Employment DesiredDate Available to Start MM slash DD slash YYYY PositionSalary DesiredDesired Number of Hours Per WeekAre you employed now? Yes No May we contact your present employer? Yes No Are you legally authorized to work in the U.S.? Yes No Any U.S. Military Service?Education HistoryHigh School Name/LocationYears AttendedDid you graduate? Yes No College Name/LocationYears AtendedDid you graduate? Yes No Trade, Business or Other School/LocationYears AtendedDid you graduate? Yes No Special Training?Special Skills?Work ExperienceName and Address of EmployerPhone #Dates EmployedSalaryPositionName and Address of EmployerPhone #Dates EmployedSalaryPositionName and Address of EmployerPhone #Dates EmployedSalaryPositionPersonal References(Names of three people not related to you, whom you have known at least one year)*NameAddressPhoneHow KnownYears Known Basic physical requirements for most positions: Do you have any physical limitations or injuries that would prevent you from performing any of the following: Lifting heavy objects (at least 30 lbs) Being on your feet for long periods of time Being exposed to extreme cold temperatures for prolonged periods of time Physical Limitations Yes No Are there any specific jobs for which you would rather not be considered?Authorization: “I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damages that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws”Signature*Date*CAPTCHACommentsThis field is for validation purposes and should be left unchanged. Δ
