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.