Application Form 2011.pub

GRAND COUNTRY EMPLOYMENT APPLICATION
1945 W. 76 Country Blvd. • Branson, MO 65616 • (417) 334-3919
This application for employment will not be considered unless fully completed
to the satisfaction of Grand Country. Please print the entire application in ink.
Date: ______________________________
Name: ____________________________________________________
(First)
(Middle)
SS#: _________ - ________ - __________
(Last)
Permanent Address: __________________________________________________________________________________
(Street)
(_____) _______________________
(City)
(State)
(_____) _______________________
Main Phone
Mobile Phone
(Zip)
_____________________________
Email
GENERAL DATA
Have you ever worked or studied under another name?
Yes
No
Have you ever been employed by this company before?
Yes
No
If yes, when and where? __________________________
If yes, what name? ___________________________
Reason for leaving: __________________________________
Do you meet all requirements to legally work in the USA?
Yes
No
Have you applied with Grand Country this calendar year:
Yes
No
Have you ever been convicted of any MISDEMEANOR or FELONY?
Yes
No
If yes, when and where? Please explain the circumstances: ___________________________________________________________
(Note: A conviction will not necessarily be a bar to employment. Factors such as age and time of the offense, seriousness and nature of the violation
and whether the offence is substantially related to applicant’s ability to perform the job applied for and rehabilitation will be taken into consideration.)
As of TODAY, if you are under 18 years of age,
Please check ONE of the following:
14 years old
What type of job are
you interested in?
Seasonal, Full-time
Seasonal, Part-time
Year-round
(attach resume)
Position applying for:
1. ________________
2. ________________
15 years old
What department(s) are
you interested in?
Grand Country Inn
Splash Country Waterpark
Papa Grands/Glenn’s Custard
Grand Country Buffet
Mining Company Grill
Grand Country Shoppes
Grand Country Music Hall
Indoor Mini Golf
Fun Spot Arcade
Maintenance
Custodial
Circle Highest Grade Completed in School:
16 years old
17 years old
Note your availability
Anytime
Earliest Time
Latest Time
____________Monday____________
____________Tuesday____________
___________Wednesday___________
____________Thursday____________
_____________Friday_____________
____________Saturday____________
_____________Sunday_____________
High School:
9
10
School/Location
11
12
GED
College: AA
N/A
How were you referred to
Grand Country?
Walk-in
Web Site
Past Visitor/Guest
Employee (first/last name)
________________________
Advertisement (source)
________________________
Other: (please specify)
________________________
BA/BS
MA
Type of Degree/Certificate Received
High School
College/Trade
Graduate School
Do you have relatives working at Grand Country?
Relative’s Name
Yes
No
Relationship
If yes, complete the following:
His/Her Work Location
Ph.D.
EMPLOYMENT HISTORY
Begin with your present or most recent job: include military service
(a) Company Name/Address/Phone
City
State
Phone No.
_________________________________________________________________________________________________
Dates of employment: From: ___________ To: __________
Job Title: ____________________________________
List main duties and assignments, tools, or equipment used, etc.: ____________________________________________
_________________________________________________________________________________________________
Reason for leaving: ____________________
(b) Company Name/Address/Phone
Hourly Rate/Salary: ____________ Eligible for rehire?
City
State
Yes
No
Phone No.
_________________________________________________________________________________________________
Dates of employment: From: ___________ To: __________
Job Title: ____________________________________
List main duties and assignments, tools, or equipment used, etc.: ____________________________________________
_________________________________________________________________________________________________
Reason for leaving: ____________________
(c) Company Name/Address/Phone
Hourly Rate/Salary: ____________ Eligible for rehire?
City
State
Yes
No
Phone No.
_________________________________________________________________________________________________
Dates of employment: From: ___________ To: __________
Job Title: ____________________________________
List main duties and assignments, tools, or equipment used, etc.: ____________________________________________
_________________________________________________________________________________________________
Reason for leaving: ____________________
Hourly Rate/Salary: ____________ Eligible for rehire?
Yes
No
REFERENCES
List names of three persons, not employers or relatives
Name
Phone Number
Relationship
I UNDERSTAND AND AGREE TO THE FOLLOWING:
I grant Grand Country, its subsidiaries, affiliates, licensees, successors and assignees (hereafter collectively referred to as “GC”), the right to use my name, voice, musical renditions, and my likeness,
image and picture of me for any lawful purpose whatsoever, regardless of whether or not I am ever employed by or remain employed by GCS. I waive my right to inspect and/or approve the finished product
or the advertising copy. I also release, discharge, and agree to save and hold GC harmless from any liability by reason of blurring, distortions, alterations, optical illusions or use in composite form, whether
intentional or otherwise, that may occur or be produced in the taking of the pictures or recording or in the processing or completion of the finished product. All work performed or products produced by me
are the property of GC.
I understand and agree that nothing in this Employment Application or in the granting of an interview creates an employment contract between GC and myself for either employment or for the providing of
any benefit. No promise regarding employment has been made to me. If I am employed by GC, I agree to conform to the rules and regulations of the company and agree that my employment and
compensation can be terminated at will, at any time with or without cause or notice, at the option of the company or myself. I agree that GC may condition a job offer to be based on the satisfactory
outcome of a medical examination or inquiry. After a conditional job offer has be made, I hereby consent to drug/alcohol tests, including, but not limited to, a urine, hair, breath, and/or blood test, and I
authorize the release and disclosure of the results of any such test to GC for its use and internal communication. I release and fully discharge GC Company, and doctor(s), laboratory or facility which performs
any such tests for the disclosure of such information to my employer. I also understand that all job offers are continent upon pre-approved physical ability to perform essential job functions, with or without
accommodation. I authorize GC to supply my employment record, in whole or in part, and in confidence to any prospective employer, government agency, or other party, with a legal or proper interest. I
agree that any charges against me for property belonging to GC will be paid by me prior to the termination of my employment. I also agree that charges for property may be deducted from any moneys due
to me from GC.
I understand that the information in which I have supplied may be checked and that any false statement or omission of material facts may result in no offer of employment or discharge if already employed.
I consent to having GC contact anyone it feels appropriate to investigate or verify and information I have given, or to discuss my background, past performance, or suitability for employment. This document
and all other personnel information when completed and signed becomes property of Grand Country.
SIGNATURE: _____________________________________________
DATE: ___________________________
(My signature means that I have read, understand, and agree with the statement above)
Grand County is an Equal Opportunity Employer.
Revised 2011