We're Hiring Enjoy what you do? Being with others who appreciate you? Join us "*" indicates required fields The Clair Winston House, LLC 132 W. Stansell Avenue Macclenny Florida 32063 Instructions: Answer all questions. Sign and date the form. PERSONAL INFORMATION: * First Name Middle Name Last Name * Street Address City State ZIP Code Phone Number*Are you eligible to work in the United States? Yes No If you are under age 18, do you have an employment/age certificates? Yes No Have you been convicted of or pleaded no contest to a felony within the last five years? Yes No If yes, please explain:POSITION/AVAILABILITY: Position Applied For Days/Hours Available* Monday Tuesday Wednesday Thursday Friday Saturday Sunday Hours Available: From To What date are you available to start work? EDUCATION: Name and Address Of School - Degree/Diploma - Graduation DateSkills and Qualifications: Licenses, Skills, Training, AwardsEMPLOYMENT HISTORY: Present Or Last Position: Employer: Address: Supervisor: Phone*Email* Position Title: From: To: Responsibilities:Salary:Reason for Leaving: Previous Position: Employer: Address:Supervisor: Phone*Email* Position Title: From: To: Responsibilities:Salary:Reason for Leaving: May We Contact Your Present Employer? Yes No References: Name/Title Address PhoneI certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. SignatureDate Month Day Year NameThis field is for validation purposes and should be left unchanged. JOB APPLICATION
