<p>EMPLOYMENT APPLICATION Saybrook Point Inn and Spa is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, religion, sex, national origin, age, disability, genetic information, gender identity or expression, or veteran status. NAME EMAIL ADDRESS:</p><p>ADDRESS CITY STATE ZIP</p><p>HOME PHONE# CELL PHONE # ( ) ( ) POSITION(S) APPLIED FOR DATE AVAILABLE FROM: TO:</p><p>Since our policy restricts one family member supervising another, we would like to know if you have any relatives now employed by this company? Yes ______No______if yes, give name, position and location.</p><p>Are you able to perform all the essential functions of this position with or without an accommodation? Yes ( ) No ( )</p><p>Please describe below which functions, if any, you will need an accommodation to perform, and explain what type of accommodation you will need:</p><p>Please indicate: Full time ______Part Time ______Temporary ______Summer ______Minimum Salary Desired ______Number of Hours per Week Desired ______</p><p>Please Indicate the number of hours you are available to work during Are you at Both the day and evening shifts for each day listed: least 16 Shift Sun Mon Tue Wed Thurs Fri Sat years of age? Days Nights Are you legally permitted to work in the U.S.? If hired do you have a reliable means of transportation to get to work? Yes ( ) No ( ) Yes ______No ______How were your referred to us?  Employee (Please give employee’s name) ______ Employee Agency (Please enter name of agency) ______ Newspaper (Please specify name of paper) ______ Other (please Specify) ______Have you ever been employed by Saybrook Point Inn, Inc? Yes No If yes when? ______Have you ever been convicted of a felony? Yes No If yes, give date, place and nature of crime. (Convictions will not necessarily disqualify applicant; each case is considered)</p><p>Business and Equipment Skills (Please Specify):</p><p>List Professional Memberships, Licenses, etc.:</p><p>Number: ______Expiration Date: ______U.S. MILITARY SERVICE DATA Branch:______List Special Training or Skills: ______</p><p>Employer/Location:</p><p>From To Position: Salary: Month Year Month Year Reason for leaving:</p><p>May we contact employer for reference? Yes ______No ______If yes, supply name, position and phone number of contact:</p><p>Employer/Location:</p><p>From To Position: Salary: Month Year Month Year Reason for Leaving:</p><p>May we contact employer for reference? Yes ______No ______</p><p>If yes, supply name, position and phone number of contact:</p><p>Education Name, City and State of School Course/Major Dates Degree</p><p>High and/or Trade school</p><p>College/Trade school </p><p>Other</p><p>References (other than relatives): Name Address/Telephone How Acquainted 1. 2. In case of emergency, notify: Name: Phone: I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Saybrook Point Inn and Spa to verify their accuracy and to obtain reference information on my work performance. I hereby release Saybrook Point Inn and Spa from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.</p><p>I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.</p><p>I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause. </p><p>______Signature of Applicant Date Interviewed by: Hired by:</p>