Job Application – The Country Christmas Loft

Countdown to Valentine's Day: 16 days, St Patrick's Day: 47 days, Easter: 66 days, Halloween: 275 days, Hanukkah: 318 days, Christmas: 330 days

(802) 985-4166
3155 Shelburne Rd
Shelburne, VT 05482

The Country Christmas Loft is an Equal Opportunity Employer and considers all candidates for employment equally regardless of race, color, national origin, sex, age, gender or handicap.

Date:

Name: Last

First

Middle

Current Address:

City

State

Zip Code

Telephone #: (home)

(mobile)

Previous Address:

City

State

Zip Code

Position Applied For:

If hired, date available:

Min. Salary Required:

Email Address:

Are you at least 16 years of age?

Yes No

Are you related to anyone employed by Country Christmas Loft?

Yes No

If so, whom?Relationship:

Availability

	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Start
Finish

EDUCATION & Special Skills

Type of School	Name & Location of School	Dates From / To	Graduate Date	Degree	Major Subject	Minor Subject
High School
College(s)
Graduate School
Technical, Business or Other

Languages (besides English)

Language	Skills
	Read	Write	Speak

EMPLOYMENT HISTORY

Start with your present or most recent position. Include experience in the armed forces of the US.
Do NOT use "see resume"; please fill each section completely.

Date:

Wage:

Business Name & Address:

Phone Number:

Type of Business:

Title & Main Responsibilities:

Name / Title of Supervisor:

Department:

Reason for seeking new employment:

May we contact this employer now? Yes No

Date:

Wage:

Business Name & Address:

Phone Number:

Type of Business:

Title & Main Responsibilities:

Name / Title of Supervisor:

Department:

Reason for seeking new employment:

May we contact this employer now? Yes No

REFERENCES

Professional References

Name and Job Title:	Home # / Mobile #:	Relationship:
		+ Best Time to Call:
		+ Best Time to Call:
		+ Best Time to Call:
		+ Best Time to Call:

I certify that the statements made in this application are true and correct to the best of my knowledge and that any deliberate falsification could result in termination of my employment. Permission is hereby granted to the Country Christmas Loft to obtain verification of the statements made herein and to obtain employment references. All reference information will be confidential and will be considered the property of the Country Christmas Loft.

Signature of Applicant

Date