Employment

First Name

Last Name

Street Address

Phone Number

Your Email

City

Zip Code

MI

State

Are You 18 Years or Older?

YesNo

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?

YesNo

Position(s) applying for

Date available to start

Hours per week

Pay required

Full Time or Part Time

Have you ever applied to this company before?

YesNo

If yes, please list the date(s) and position(s)

Have you ever been employed by this company before?

YesNo

If yes, please list the date(s), position(s) and reason for leaving.

Educational Information

Grammar School

Name and Address

Last year completed

6th7th8th

High School

Name and Address

Last year completed

9th10th11th12th

Major Course of Study

Graduated

YesNo

College

Name and Address

Last year completed

1st2nd3rd4th

Major course of study

Graduated

YesNo

Trade, Business, or Correspondence School

Name and Address

Last year completed

1st2nd3rd4th

Major course of study

Graduated

YesNo

General Information

Subjects of special study or research work

Special Skills

Activities: (Civic, Athletic, Etc.)

Exclude organizations, the name of which indicates the race, creed, sex, age, marital status, color or nation of origin of its members

Military Service

Are you a member of the U.S. Military or Naval Service

YesNo

If yes, what rank and current status?

Employment History

List below past and present employment (full-time, part-time, and self-employment), beginning with your most recent position.

Present or most recent employer: (1)

Company Name

Company Street Address

City

State

Zip Code

Company Telephone #

Position

Employed From - To

Reason for Leaving

Supervisor's Name

Wage/Salary

Your Job Duties

Next Previous Employer: (2)

Company Name

Company Street Address

City

State

Zip Code

Company Telephone #

Position

Employed From - To

Reason for Leaving

Supervisor's Name

Wage/Salary

Your Job Duties

Next Previous Employer: (3)

Company Name

Company Street Address

City

State

Zip Code

Company Telephone #

Position

Employed From - To

Reason for Leaving

Supervisor's Name

Wage/Salary

Your Job Duties

Next Previous Employer: (4)

Company Name

Company Street Address

City

State

Zip Code

Company Telephone #

Position

Employed From - To

Reason for Leaving

Supervisor's Name

Wage/Salary

Your Job Duties

References

Give the names of three persons not related to you, whom you have known for at least one year.

Reference 1

Name

Known how long?

Full Address

Telephone #

Reference 2

Name

Known how long?

Full Address

Telephone #

Reference 3

Name

Known how long?

Full Address

Telephone #

By submitting this form to New and Gauley River Adventures, I certify that all the information on this application is true and completer, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without noticed, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any other specific period of time, or to make any agreement contrary to the foregoing.

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