Employee Application

First Name^*

Middle Initial

Last Name^*

Date of Birth

Gender

Address 1^*

Address 2

City

State^*

Zip^*

Phone^*

Alternative Phone

Email^*

Referred By

Are you 18 years or older?

Are you a citizen of the United States?^*

If no, are you authorized to work in the U.S.?

Have you been convicted of a crime in the past 10 years, excluding misdemeanors & summary offenses?^*

If yes, explain conviction

Position Desired^*

Date You Can Start

Desired Salary

Availability

Are you employed now?

If so, may we contact employer?

Can you work weekends & holidays?

Do you have your own transportation?

If no transportation, explain

Ever applied to Gulfarium?

For what position?

Applied for position when?

High School Name

High School Location

Years Attended High School

Did You Graduate High School?

High School Subjects Studied

College Name

College Location

Years Attended College

Did You Graduate College?

Trade or Other School Name

Trade or Other School Location

Years Attended Trade or Other School

Trade or Other School Years Attended

Employer 1 Name

Employer 1 Dates

Employer 1 Address

Employer 1 Contact Person

Employer 1 Contact Phone Number

Employer 1 Salary

Employer 1 Position

Employer 1 Reason For Leaving

Employer 2 Name

Employer 2 Dates

Employer 2 Address

Employer 2 Contact Person

Employer 2 Contact Phone Number

Employer 2 Salary

Employer 2 Position

Employer 2 Reason For Leaving

Employer 3 Name

Employer 3 Dates

Employer 3 Address

Employer 3 Contact Person

Employer 3 Contact Phone Number

Employer 3 Salary

Employer 3 Position

Employer 3 Reason For Leaving

Special Skills

U.S. Military or Naval Service

Rank

Reference 1 Name

Reference 1 Address

Reference 1 Phone

Reference 1 Occupation

Reference 1 Number Of Years Known

Reference 2 Name

Reference 2 Address

Reference 2 Phone

Reference 2 Occupation

Reference 2 Number Of Years Known

State names of relatives and friends working for us:

Resume

Organizations

First aid/CPR

Lifeguard Certification Pool

Lifeguard Certification Waterfront

SCUBA Certification