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Position of Interest (check all that apply)

HousekeeperLaundry AttendantDriver/Lobby PersonReservationistOvernight AuditorMaintenance Helper/CustodianBartenderRestaurant ServerHost/HostessBus PersonBanquet Set-up CrewBanquet ServerDishwasherLine CookBreakfast Bar AttendantManagement/SupervisorSecurity Officer

Referral Source:
AdvertisementEmployeeRelativeWalk-inEmployment AgencyIndeedOther

Name

Address

Cell Phone

Home Phone

Email Address

If you are under 18, can you furnish a work permit?
YesNo

Have you ever been employed here before?
YesNo

Are you legally eligible for employment in the United States?
YesNo

List anyone you know working for us currently:
Date available to start working

Type of employment desired (check one):

Full timePart timeSeasonalInternship

Hours available

Sunday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight
Monday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight
Tuesday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight
Wednesday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight
Thursday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight
Friday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight
Saturday Not AvailableAvailable AnytimeMorningsAfternoonsEveningsOvernight

Employment History

List your last 3 employers, starting with the most recent. For application to be considered, candidate must provide full address and tele-
phone number of previous employers.

Employer Name
Telephone

Address

Job Title
Start Date
End Date
Salary
Reason for leaving
Immediate Supervisor and Title
Job Responsibilities
May we contact for reference?
YesNoLater
Employer Name
Telephone

Address

Job Title
Start Date
End Date
Salary
Reason for leaving
Immediate Supervisor and Title
Job Responsibilities
May we contact for reference?
YesNoLater
Employer Name
Telephone

Address

Job Title
Start Date
End Date
Salary
Reason for leaving
Immediate Supervisor and Title
Job Responsibilities
May we contact for reference?
YesNoLater
Explain any gaps in employment history

Have you ever been discharged or asked to resign from a job?
YesNo

Have you ever been convicted of a crime?
YesNo
*A criminal conviction is not an automatic disqualifier for employment. However, Crown American Associates generally does not hire individuals who have been convicted of an offense, if the conviction is reasonably related to the job, including crimes involving dishonesty, violence, drugs and sex crimes. Applicant does not have to disclose the existence of any conviction which has been erased, expunged, sealed, which was the result of youthful offender adjudication, or for which the applicant has received an absolute pardon

Education

Please indicate education or training which you believe qualifies you for the position you are seeking.

High School Name

Address

Major Course of Study
Grade Completed or Degree(s)
Business/Trade School Name

Address

Major Course of Study
Grade Completed or Degree(s)
College Name

Address

Major Course of Study
Grade Completed or Degree(s)
Graduate Name

Address

Major Course of Study
Grade Completed or Degree(s)
List any other experience, skills, scholastic honors, offices held, and/or other qualifications including hobbies, which you believe should be considered in evaluating your qualifications for employment. Please indicate prior volunteerism or military service which you would like considered in connection with your application for employment.
Please provide any additional information you believe would be of value in considering you for employment:

References

List at least 3 business/work references who are not related to you and are not previous supervisors. If not applicable, list 3 school or personal references who are not related to you.

Reference Name
Occupation

Address

Phone Number
Years Known
Reference Name
Occupation

Address

Phone Number
Years Known
Reference Name
Occupation

Address

Phone Number
Years Known
Reference Name
Occupation

Address

Phone Number
Years Known

It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer’s service if I have been employed.
I give the Employer the right to investigate all references and to secure additional information about me, if job related. I understand such information may be obtained from social media sites among other resources. I hereby release from liability the Employer and its representatives for seeking such information and all other persons corporations, or organizations for furnishing such information.
The Employer is an Equal Opportunity Employer. The Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state, or federal law. I have been made aware that I may be asked to complete a background screening, dependent upon the position for which I am applying and that the Employer
conducts various drug/alcohol testing as outlined in the Drug Free Workplace Policy. I understand that the Employer may review various social media outlets to secure additional information which may be used against me in the hiring decision if the information is reasonably related to the job.
This application is current for only 90 days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will be necessary to fill out a new application.
I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without prior notice. I understand that no representative of the Employer has the authority to make any assurances to the contrary.

I agree.