Gators Dockside Careers Form – Fill Out and Use This PDF

	AN
	EQUAL
GATOR’S DOCKSIDE	OPPORTUNITY
APPLICATION FOR EMPLOYMENT	EMPLOYER

We receive applications and hire employees without regard to race, color, sex, religion, age, genetic information, national origin, marital status, disability, veterans status and citizenship status, or any other protected category. The receipt of this application does not mean that job openings exist and does not obligate us in any way. We appreciate your interest in our organization.

					Date:____________________________
			PERSONAL INFORMATION
					.
Name___________________________________________________________________________					Social Security No.________________________________________
First		Middle Initial	Last
Present address___________________________________________________________________					Home or nearest phone_______________________________________
No.	Street	City	State	Zip

How long have you lived at above address?___________________________________________________________________________________________________________

Previous address __________________________________________________________________							How long did you live there?___________________________________
No.	Street			City	State	Zip
Are you over the age of 18? • Yes • No			If no, employment is subject to verification that you are of minimum legal age.
Are you currently eligible to work in the U.S.?			•	Yes • No	Can you provide documentation that you are legally eligible to work in the U.S.? • Yes			• No
				EMPLOYMENT INFORMATION
Position applying for______________________________________________________________							Date available for work_______________________________________
Shift Preference • Before 4pm •		After 4pm	•	Any			What salary or pay rate do you expect?___________________________
Type of employment •	Full Time	• Part Time

What days and hours are you available to work? Days____________________________________ Hours_________________________________________________________

Have you ever applied for a job with us before?			• Yes	• No	When?____________________________________________________________________________
Have you ever been bonded?	• Yes	•	No	Have you ever been refused bond?		•	Yes • No If so, state reason and date.___________________
Have you ever been convicted of a crime, pled no contest or had adjudication withheld? • Yes						• No	If so, explain__________________________________________

______________________________________________________________________________________________________________________________________________

Do you use illegal drugs?	• Yes	• No
Does your present employer know of your plans to change employment?			• Yes	• No	Why do you desire to make a change?_____________________

______________________________________________________________________________________________________________________________________________

Have you ever held a position of trust (handling money or confidential material)?				• Yes	• No
Do you have steady transportation to work?	•	Yes	• No
Have you ever been discharged or asked to resign?		• Yes	• No

Are there any other experiences, skills, or qualifications you have that specifically relate to working here?__________________________________________________________

Do you have any friends or relatives that currently work here? • Yes • No			Name_________________________________________________________________
Can you perform the essential functions of the job for which you are applying, with or without reasonable accommodation? • Yes				• No
		EDUCATION INFORMATION
SCHOOLING	YEARS	DEGREE REC.	NAME OF SCHOOL	LOCATION	DID YOU
	COMPLETED	AND MAJOR SUB.			GRADUATE?
GRAMMAR OR
HIGH SCHOOL
TRADE BUS., OR
CORRESPONDENCE
GRADUATE
SCHOOL

Describe any other specialized or professional training (such as business, technical or nursing school). Include study courses given through public or private employment, State whether degree or certificate was received.____________________________________________________________________________________________________________

NEWHIRE_APPGD_JAN12_12552

PRIOR WORK RECORD (Start with most recent or present employer)

1)Name & Address of Most Recent Employer

Telephone No.

Immediate Supervisor (Name & Position)

Date Hired___________________________________________ Starting Rate____________________________________________

Your Job Title & Duties

Date Left____________________________________________ Last Rate_______________________________________________

Reason for leaving:

2)Name & Address of Most Recent Employer

Telephone No.

Immediate Supervisor (Name & Position)

Date Hired___________________________________________ Starting Rate____________________________________________

Your Job Title & Duties

Date Left____________________________________________ Last Rate_______________________________________________

Reason for leaving:

3)Name & Address of Most Recent Employer

Telephone No.

Immediate Supervisor (Name & Position)

Date Hired___________________________________________ Starting Rate____________________________________________

Your Job Title & Duties

Date Left____________________________________________ Last Rate_______________________________________________

Reason for leaving:

May we contact the employers listed above? __________ If not, indicate by No. which one(s) you do not wish us to contact_______

REFERENCES (Do not list relatives or former employers) Name________________________ Address _______________________ Phone______________________ Occupation___________

Name________________________ Address _______________________ Phone______________________ Occupation ___________

Name________________________ Address _______________________ Phone______________________ Occupation___________

The facts set forth above in my application for employment are true and complete. I understand that if employed, false statements or omission of information on this application, a. resume, or other applicant information provided may be considered sufficient reason for dismissal. I understand that consumer reports which may contain public record information may be requested from the reporting agency. These reports may include information as to my character, work habits, performance, and experiences along with reasons for termination of past employment from previous employers. Further, I understand that you may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil, and other experiences. I understand that I have the right to make a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigative consumer report.

I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from any liability or damages on account of having furnished such information. I understand that employment at this organization is on an "at will" basis, and includes no guarantee, contract, or promise of employment for any specific length of time.

Signature of Applicant

Date

NEWHIRE_APPBACK_JAN12_12552