Osterville Fish
Application for Employment

We are an equal opportunity employer and do not unlawfully discriminate in employment.  No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

Applicant name:    Date: Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 , Year 2009 2010
Position(s) applied for or type of work desired:
Street Address:   Town:   State:   Zipcode:
Telephone #:     Cell phone #:
Social Security #:
Date you will be able to start work:    Salary Desired:

Are you available to work nights and weekends?  yes no
Do you have any objection to working overtime if necessary? yes no
Have you ever been employed by our organization? yes no
Would you be able to work at our Barnstable location?  yes no
Would you be able to work off site at our catered clambakes, if needed? yes no
Do you have experience working with the public? yes no
Have you worked a cash register before? yes no
Have you been convicted of a crime in the last 7 years? yes no
If yes, please explain (a conviction will not automatically bar employment):

How were you referred to us?


Employment History
Please provide all employment information for your past four employers starting with the most recent.

Employer 1: Position Held:
Address: Telephone #:
Dates employed:  from to    Salary:
Job summary:
Reason for leaving:

Employer 2: Position Held:
Address: Telephone #:
Dates employed:  from to    Salary:
Job summary:
Reason for leaving:

Employer 1: Position Held:
Address: Telephone #:
Dates employed:  from to    Salary:
Job summary:
Reason for leaving:

Other Skills and Qualifications
Summarize any job-related training, skills, licenses, certificates, and/or other qualifications:

Educational History
List school name and location, years completed, course of study, and any degrees earned:
High school:
College:
Technical Training:
Other:
References
List 3 references names, telephone numbers, and years known (do not include relatives or employers):
1.
2.
3.

I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also herby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

By submitting this application you agree that all statements made herein are accurate and true to the best of your knowledge.

By clicking the submit button you are legally signing this document.