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Front Desk Staff

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Personal Information

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Job Information

Please provide the position you are applying for


Please correct your Are You Currently Employed?.


Please correct your Can we contact your current employer?.

Please provide the date you can start



Please correct your Do you have any relatives employed by the Company or its affiliates?.


Please correct your Are you at least 18 years old?.



Education Information

Note Highest Grade Completed


Please correct your High School (by grade).


High School

College / University

Vocational, Business, Other


Previous Employers

Employer #1

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Please correct your Employer Name.

Please correct your Employer Address.

Please correct your Supervisor Name.

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Please correct your Starting Salary.

Please correct your Ending Salary.

Please correct your Job Title.

Please correct your Reason for Leaving.

Please correct your Duties and Responsibilities.


Employer #2


Employer #3


Employer #4


Please list three professional references.

Reference #1

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Please correct your Company.

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Reference #2

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Please correct your Last Name.

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Please correct your Company.

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Reference #3

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General Information

Please correct your Have you ever worked for our company or any of its affiliates before?.

Please correct your If hired, will you be able to work overtime?.

Please correct your Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accommodation?.


Electronic Agreement

The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery.

I authorize the Company to inquire and obtain information from all referenced employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me on this application, resume' or job interview. I hereby waive any and all rights and claims I may have regarding the company for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me. I further authorize the Company to investigate my criminal records and credit/consumer check.

I understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company. I understand and agree that, if hired, my employment will be considered "at-will" and may be terminated by me or the Company at any time and for any reason.

If employed, I will be required to provide original documents that verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9.

Please accept the above agreement to submit your application.