Plimoth Plantation
On-line Job Application

Plimoth Plantation is an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, disability or national origin. Consistent with the Americans with Disabilities Act, applicants may request accommodations needed to participate in the application process.

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Job Information:

Position(s) applied for:

Date of Application:

mm/dd/yyyy

General Information:

Name:

Current Address:

City

State

Zip Code:

Country

Telephone

Email Address:

Education Information:

	School Name and Location	Major Course of Study	Degree Earned	Last Year Completed
High School				1 2 3 4
Tech. School				1 2 3 4
College or University				1 2 3 4
Graduate Work				1 2 3 4

Previous Employment Information:

Provide the following information of your past four employers, assignments, or volunteer activities, starting with the most recent.

From:	mm/yyyy	To:	mm/yyyy
Employer:		Telephone:

Address:

City:

State: Zip Code:

Country:

Job Title:

Job Responsibilities:

Immediate Supervisor:

Supervisor's Position:

May we contact for a Reference?

yes no

Hourly Rate/Salary:

Start: $ Final: $

Reason for leaving:

From:	mm/yyyy	To:	mm/yyyy
Employer:		Telephone:

Address:

City:

State: Zip Code:

Country:

Job Title:

Job Responsibilities:

Immediate Supervisor:

Supervisor's Position:

May we contact for a Reference?

yes no

Hourly Rate/Salary:

Start: $ Final: $

Reason for leaving:

From:	mm/yyyy	To:	mm/yyyy
Employer:		Telephone:

Address:

City:

State: Zip Code:

Country:

Job Title:

Job Responsibilities:

Immediate Supervisor:

Supervisor's Position:

May we contact for a Reference?

yes no

Hourly Rate/Salary:

Start: $ Final: $

Reason for leaving:

From:	mm/yyyy	To:	mm/yyyy
Employer:		Telephone:

Address:

City:

State: Zip Code:

Country:

Job Title:

Job Responsibilities:

Immediate Supervisor:

Supervisor's Position:

May we contact for a Reference?

yes no

Hourly Rate/Salary:

Start: $ Final: $

Reason for leaving:

Are you able to perform all of the essential functions of the job described?

yes no

Have you ever been convicted of a crime? yes no

If so, for what?

Skills and Qualifications:

Summarize any training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying:

Personal References:

(persons not related to you, whom you have known at least one year)

Name:

Relationship:

Telephone Number:

Name:

Relationship:

Telephone Number:

Name:

Relationship:

Telephone Number:

Applicant's Certification and Agreement:

I certify that the information contained in this application is correct to the best of my knowledge and understand that deliberate falsification of the this information is grounds for dismissal in accordance with Plimoth Plantation, Inc. policy at this time or anytime in the future.

I hereby understand and acknowledge that any employment relationship with Plimoth Plantation, Inc. is of an at-will nature, which means that the employee may resign at any time and the employer may discharge the employee at any time with or without cause.

I authorize the references listed above to give you and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that my result from furnishing same to you.

I understand that any employment offer is contingent upon my successful completion of the pre-employment screening process which may include a satisfactory criminal history, verification of driver’s license and satisfactory completion of any required post-offer pre-employment drug test or physical examination.

Date:

dd/mm/yy

Name: