Stage Neck Inn Mailing List Submission Form

Application for Employment

In conjunction with the Americans with Disabilities Act and the Maine Human Rights Act,
applicants may request accommodations needed to participate in the application process.

Stage Neck Inn is an equal opportunity employer dedicatedto a policy of compliance with all
Federal, State, and local laws regarding nondiscrimination in employment. Applicants are
considered for all positions without regard to race, color, religion, sex, ancestry or national origin,
age or veteran status. In addition, this Company does not discriminate on the basis of physical
or mental disability where the essential functions of the job, as reasonably accomodated, do not
require such distinction. No question on this application is intended to secure information
to be used for unlawful purposes.

You may also apply by fax (207-363-2221). Please be sure to include
ALL of the information requested in this form..

Red Fields are Required. Kindly use Initial Caps Only ... Not SOLID CAPS.
ex. Sally Jones, Anywhere Street, Your Town, etc.

First Name:

Last Name:

Mailing Address:

City:

State:

Zip:

Telephone No.:

Soc. Sec. No.:

Email:

Reenter Email:

US Citizen:

If "no", are you authorized to work in the US?

Do you work anywhere
else in your spare time?

If "yes", where?

Areas of Interest

Postion(s) applied for:

Dates available:

Salary Expecation:

Type of Schedule Desired:

(Please check ALL that apply using your Shift or Control keys)

Students Only:

Are you available to work part-time off season?

Education

Highest level of education
you have completed:

Degree(s):

Field of Study:

Vocational Courses Completed:

Last School Attended:

Address of School:

Hotel/Restaurant
Courses Taken:

Special Ratings
and/or Licenses:

Language Fluency which
may be utilized at SNI:

Employment History

Please list you last 3 employment positions with the most recent first.
Also, please explain any extended periods of unemployment.

Most-Recent Employment

Dates of Employment:

Company Name/Address:

Position/Duties:

Earnings start and present:

Name/Title of Supervisor

Reason for Leaving:

Second Most-Recent Employment

Dates of Employment:

Company Name/Address:

Position/Duties:

Earnings start and present:

Name/Title of Supervisor

Reason for Leaving:

Third Most-Recent Employment

Dates of Employment:

Company Name/Address:

Position/Duties:

Earnings start and present:

Name/Title of Supervisor

Reason for Leaving:

If applicable, please explain any periods of unemployment between the jobs listed above. Reason for Leaving:

Have you ever been terminated or asked to resign from a job (if "yes", explain below):

Three References (Name, Address, Telephone):

The information on this application is true, correct, and complete. I authorize investigation of all statements on this application and release my former employers and their agents from any liability with respect to any information that they may give. I understand that misrepresentation or omission of facts called for above is cause for dismissal at any time and that, if employed, my employment may be terminated with or without cause and without notice, by the employer or me.

Please initial here to acknowledge reading and agreeing with the above statements:

Thank you for your interest in Stage Neck Inn!

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