Employment Application
Please type or print clearly:
Date: ______E-Mail______Date of Birth: ______
Last Name: ______First Name: ______MI: ______
Street Address: ______Apt. /Ste.: ______
City: ______State: ____ Zip: ______Phone: ______
Social Security Number: ______
Position Desired (circle): Captain Crew Ticket Booth Bartender Intern Maintenance
Are you a citizen of the United States? ______
If not, can you provide proof that you have the legal right to remain and work in the United States? _____
Have you ever been convicted of a crime? ______If yes, please describe:
Have you ever worked for the Riverboat? ______If yes, from ______to ______
Reason for leaving: ______
Do you have any relatives employed by the Riverboat or are members of the Board of Directors? ______
If yes, please list names: ______
Can you swim? ______Do you have any water safety/lifesaving skills? ______
Education
High School: ______Completed? Yes No
College/University: ______Degree: ______
Completed University? Yes No If No, what year are you in (if none, put “not enrolled”): ______
Are you a veteran? _____ Service Branch: ______Selective Service Class or Reserve Status
I am willing to work (circle all that apply): Full Time Part Time Weekends
Evenings Day Time
References
Please list 3 people (not related) that you have known for more than one year:
Name: ______Phone: ______
Name: ______Phone: ______
Name: ______Phone: ______
Previous Employment History (you may attach more if needed)
List most current employer first:
Employer: ______
Address: ______
Date Employed From: ______To: ______Position Held: ______
Reason for Leaving: ______
Employer: ______
Address: ______
Date Employed From: ______To: ______Position Held: ______
Reason for Leaving: ______
Employer: ______
Address: ______
Date Employed From: ______To: ______Position Held: ______
Reason for Leaving: ______
Public Law 91-508 requires that we advise you that a routine inquiry may be made during our initial or subsequent processing of your application which will provide applicable information concerning character, general reputation, personal characteristics, and mode of living. Upon written request, additional information regarding inquiry, if one is made, will be provided. Harrisburg Area Riverboat Society, Inc. is an equal opportunity employer and selects qualified individuals for the job based upon job-related qualifications, regardless of race, color, creed, sex, national origin, or on the basis of age or handicap. I certify that any misrepresentation made in this application will be sufficient cause for cancellation of this application and/or for my separation from Harrisburg Area Riverboat
Society, Inc. I certify that the above statements have been read by me and that the statements I have made on this application are true and correct. I authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the duties of a job of which I am being considered for prior to employment or in the future during my employment with Harrisburg Area Riverboat Society, Inc.
Signature: ______Date: ______