First Name
Last Name
Today's Date
Date of Birth
Best Contact #
Email Address
Street Address
City
State
Zip
Position(s) Desired
Will you have another job while working with us?
NoYes
Location(s) Applying To
OrlandoWinter SpringsPlant City
If hired, can you submit proof of legal identity in the U.S?
I'm at least 18 or olderI'm older than 21I'm under 18
In case of an emergency, please notify:
Name
Best Contact #
Relationship
What does customer service mean to you?
What is your favorite animal and why?

TRAINING / EDUCATION / SKILLS / INTERESTS

High School Name
Location
Year Graduated
College Name
Location
Year Graduated
Major/Minor
Trade School(s) Attended
Do you have any current certifications?
(ex: Food Handler’s Certification, TIPS, etc)
Do you have any other relevant communication, information skills or classes taken that may be applicable? (please list)
Please list any special interests not including activities that indicate protected characteristics, such as race or religion

EMPLOYMENT RECORD

(PLEASE LIST MOST RECENT FIRST, OR ATTACH RESUME)

Company
From:
To:
Street Address
City
State
Zip
Supervisor’s Name
Supervisor's Title
Phone
Type of work at start
Type of work at leaving
Reason for leaving
May we contact this employer?
NoYes


Company
From:
To:
Street Address
City
State
Zip
Supervisor’s Name
Supervisor's Title
Phone
Type of work at start
Type of work at leaving
Reason for leaving
May we contact this employer?
NoYes

REFERENCES

List below three references (not a relative or former employer) whom you have known for at least five years

Name
City, State
Occupation
Best Contact #
Name
City, State
Occupation
Best Contact #
Name
City, State
Occupation
Best Contact #

Employment Disclaimer

Please read the following carefully. Your signature below is required, and acknowledges that you have read, understood and agreed to the information.

I affirm that the information contained in this application is true, complete, and accurate. I authorize investigation of all statements contained in this application form if I am considered for employment. I also authorize previous employers, personal references named, or any other person whom the company may contact, to give any and all information regarding my employment or any other information, personal or otherwise, that may or may not be on their records. I fully release all persons and entities from any and all liability or potential claims resulting from the disclosure, use or
dissemination of any such information whether it is favorable or unfavorable.

I understand that misrepresentation or material omission of the facts called for herein or receipt of unsatisfactory references may result in disqualification from employment, or, if I am hired, my dismissal from employment. I also understand that any job that I am offered will not be for any set period of time. My employment may be terminated at any time of my own free will or the will of my employer.

Applicant Signature

I certify that the above electronic signature acknowledges that I have read, understood and agreed to the information.