705 Rumney Rte 25 Date Applied ______
Rumney, NH 03266
603-536-1888
Application for Employment
Name: ______Email Address______
(Last) (Middle Initial) (First)
Local Phone: ______
Address: ______Cell Phone: ______
Address for W2 if different :______Date of Birth: ______
Educational Background:
High School: ______City/State ______
Dates Attended: ______Highest Level Attained: ______
College: ______City/State: ______
Dates Attended: ______Highest Level Attained: ______
Present or Last Employer:
Name: ______City/State______
Dates Employed: ______Phone: ______
Reason for Leaving: ______
Skills acquired ______
Position Desired: ______Part Time: ______Full Time: ______
Hours Preferred: ______
Are there any days of the week that you are unable to work? ______Yes ______No If Yes, please list ______
Do you have adequate transportation to and from work? ______Yes ______No
Are you acquainted with any of our present or past employees? ______Yes ______No If Yes, please list: ______
Do you have experience with any of the following?
Cash Register: ______Carpentry: ______Can You make Change? ______Food Service: ______
Restocking: ______Do you have a First-Aid Certificate? ______Are you an EMT? ______
Please explain why you want to work at Polar Caves Park: ______
In Case of Emergency Notify: Name: ______Phone: ______
Relationship: ______
Polar Caves has a bonus system that allows our staff to make an end of the season bonus. It is calculated based on position, sick days, being on time, availability, quality of work and working till the date you agree too. No bonus is paid if you leave or quit before that date.
Date you can start work: ______Date you will remain until: ______
Can you work the following holiday weekends?
Memorial Day Weekend ______Fourth of July Weekend ______Labor Day weekend ______
Weekends in September and early October? ______
Being a seasonal business being able to work weekends is essential!
Please list all Special Days that you will require Off during our Season (Mid-May through Mid October)
Date: Reason:
______
______
______
Certification
“I certify that the facts in this application are true to the best of my knowledge and understand that, if employed, falsified statements on this application will be grounds for dismissal.
I authorize the investigation of all statements contained herein and the reference listed above to give you any and all information pertaining to my previous employment and any pertinent information that they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages, be terminated at any time without prior notice.”
Date: ______Signature: ______
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