Nantucket Inn

Equal access to programs, services and employment is available to all persons. Those applicants requiring special accommodation for the application and/or interview process should notify a representative of the Human Resources Department.
Position(s) applied for
Date of application
Name
Mailing Address
City, State, Zip
,
Country
Telephone
Cell Phone Number
E-mail Address
Referral Source
 (How did you hear about us?)
If you are under 18, and it is required, can you furnish a work permit?  Yes  No
If no, please explain
Have you ever been employed here before?   Yes  No
If yes, give dates and positions
Are you legally eligible for employment in this country?  Yes  No
Date available for work
Ending Date?
What is your desired salary range?
Type of employment desired
 Full Time Part Time
 Employment History -
Starting with your most recent employer, provide the following information.
Employer #1
Telephone #
Street Address
City/State
Dates employed:
 From To
Compensation (Starting)
 Hourly Salary $ per
  Commission/Bonus/Other Compensation
Compensation (Final)
 Hourly Salary $ per
  Commission/Bonus/Other Compensation
Starting job title
Final job title
Immediate supervisor and title (for most recent position held)
Why did you leave?
May we contact for reference?
 Yes No Later
Summarize the type of work performed and job responsibilities.
What did you like the most about your position?
What were the things you liked least about the position?
Employer #2
Telephone #
Street Address
City/State
Dates employed:
 From To
Compensation (Starting)
 Hourly Salary $ per
 
 Commission/Bonus/Other Compensation
Compensation (Final)
 Hourly Salary $ per
 
 Commission/Bonus/Other Compensation
Starting job title
Final job title
Immediate supervisor and title (for most recent position held)
Why did you leave?
May we contact for reference?
 Yes No Later
Summarize the type of work performed and job responsibilities.
What did you like the most about your position?
What were the things you liked least about the position?
Employer #3
Telephone #
Street Address
City/State
Dates employed:
 From To
Compensation (Starting)
 Hourly Salary $ per
 
 Commission/Bonus/Other Compensation
Compensation (Final)
 Hourly Salary $ per
  
 Commission/Bonus/Other Compensation
Starting job title
Final job title
Immediate supervisor and title (for most recent position held)
Why did you leave?
May we contact for reference?
 Yes No Later
Summarize the type of work performed and job responsibilities.
What did you like the most about your position?
What were the things you liked least about the position?
Skills and Qualifications
Summarize any special training, skills, licenses and/or certificates that may assist you in performing the position for which you are applying.
Please also list all computer skills
Educational Background -
Starting with your most recent school attended, provide the following information.
School #1
City/State
Years Completed
Completed
 Diploma Degree Certificate Other GED
GPA/Class Rank
Major/Minor
School #2
City/State
Years Completed
Completed
 Diploma Degree Certificate Other GED
GPA/Class Rank
Major/Minor
School #3
City/State
Years Completed
Completed
 Diploma Degree Certificate Other GED
GPA/Class Rank
Major/Minor
References -
List name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.
Reference #1 Name
Title
Relationship to You
Telephone
Number of Years Known
Reference #2 Name
Title
Relationship to You
Telephone
Number of Years Known
Reference #3 Name
Title
Relationship to You
Telephone
Number of Years Known
Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 90 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president. I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.
DO NOT CHECK UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
Applicant's Name Date
AN EQUAL OPPORTUNITY EMPLOYER