Poipu Bay Application for Employment

Personal Information

Last Name

First Name

Middle

City

State

Zip

Phone

Position Desired

Are you legally eligible for employment in the United States?
yesno

When will you be available to begin work?

Have your ever applied for employment with us?
yesno

If yes, when?

Employment History

Please give accurate, complete employment record.

Previous Employer 1

Company Name

Address

Telephone

Name of Supervisor

Employed From

Employed Until

State Job Title and Describe Your Work

Reason for Leaving

Can we contact this employer?
yesno

If no, please indicate the reason.

Previous Employer 2

Company Name

Address

Telephone

Name of Supervisor

Employed From

Employed Until

State Job Title and Describe Your Work

Reason for Leaving

Can we contact this employer?
yesno

If no, please indicate the reason.

Previous Employer 3

Company Name

Address

Telephone

Name of Supervisor

Employed From

Employed Until

State Job Title and Describe Your Work

Reason for Leaving

Can we contact this employer?
yesno

If no, please indicate the reason.

References

Name

Telephone

Relationship

Name

Telephone

Relationship

Name

Telephone

Relationship

Resumé or Cover Letter

You can attach an optional resumé and/or cover letter. File can be a doc, docx, odf, pdf, or txt and must be 2mb or less.

Optional Attachment 1

Optional Attachment 2

It is the policy of this company to hire only U.S. citizens and aliens who are authorized to work in this country. As a condition of employment, you will be required to produce original documents establishing your identity and authorization to work; and to complete the U.S. Citizenship and Immigration Services’s Form I-9.

The information provided in this Application for Employment is true, correct, and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal.

I hereby authorize any investigation of the above related work experience, education, or reputation information or purposes of consideration of my application for employment.

I understand that the acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. I understand that if I am employed, my employment is "at will" and can be terminated at any time; either by myself or the Company, with or without cause or reason and with or without notice.

Today’s Date

Applicant’s Signature (type)

90108