THE LIGHTHOUSE INN PO BOX 128, W. DENNIS, MA 02670 508-398-2244, FAX 508-398-5658 WEBSITE: www.lighthouseinn.com e-mail: inquire@lighthouseinn.com APPLICATION FOR EMPLOYMENT FULL NAME_________________________________________DATE OF APPLICATION____________ PERMANENT ADDRESS________________________________________________________________ CITY______________________________________________STATE___________ZIP_______________ CURRENT MAILING ADDRESS__________________________________________________________ CITY____________________STATE______ZIP_________HOME/CELL PHONE___________________ E-MAIL ADDRESS______________________________________________________________________ EDUCATION Please list, starting with the last school attended or current school School # Years Complete Diploma/Degree/Major IF YOU ARE CURRENTLY IN SCHOOL, FALL REGISTRATION DATE_________________________________ DATE FALL CLASSES BEGIN_____________DO YOU NEED TO RETURN TO SCHOOL EARLY?__________ DO YOU HAVE AUTHORIZATION TO WORK IN THE UNITED STATES?___________ POSITION DESIRED________________________________________SALARY/WAGE NEEDS_______________ EARLIEST DATE YOU CAN BEGIN WORK________________________________________________________ LATEST DATE YOU CAN WORK THROUGH______________________________________________________ DO YOU HAVE SUMMER HOUSING?_____________________________________________________________ HOBBIES AND INTERESTS______________________________________________________________________ HOW DID YOU HEAR ABOUT LIGHTHOUSE INN?________________________________________________ PERSONAL REFERENCES OTHER THAN THOSE LISTED IN PREVIOUS EMPLOYMENT SECTION (NOT RELATIVES) 1. NAME_________________________________________________PHONE_______________________ 2. NAME_________________________________________________PHONE_______________________ 3. NAME_________________________________________________PHONE_______________________ PREVIOUS EMPLOYMENT (LIST LAST JOB FIRST) PLACE OF EMPLOYMENT_______________________________SUPERVISOR____________________ ADDRESS_____________________________________________PHONE__________________________ CITY______________________________________________STATE___________ZIP_______________ POSITION HELD__________________________________DUTIES_______________________________ DATES EMPLOYED: FROM________________________TO___________________________________ REASON FOR LEAVING_________________________________________________________________ ----- ----- ----- ----- ----- ----- ----- ----- PLACE OF EMPLOYMENT_______________________________SUPERVISOR____________________ ADDRESS_____________________________________________PHONE__________________________ CITY______________________________________________STATE___________ZIP_______________ POSITION HELD__________________________________DUTIES_______________________________ DATES EMPLOYED: FROM________________________TO___________________________________ REASON FOR LEAVING_________________________________________________________________ ----- ----- ----- ----- ----- ----- ----- ----- PLACE OF EMPLOYMENT_______________________________SUPERVISOR____________________ ADDRESS_____________________________________________PHONE__________________________ CITY______________________________________________STATE___________ZIP_______________ POSITION HELD__________________________________DUTIES_______________________________ DATES EMPLOYED: FROM________________________TO___________________________________ REASON FOR LEAVING_________________________________________________________________ Lighthouse Inn is an Equal Opportunity Employer This is an application ONLY; a personal interview is required I HEREBY CERTIFY THAT ALL OF THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT. ______________________________________________________________________________________________ SIGNATURE DATE