Housekeeping Room Attendant $16.00 Hour

Education History High School:* Highest Grade Completed:*

* Yes

* No

College Name: Degree Completed: Degree Completed: Yes No Type of Degree: Major & Minor Studies: Other College: Degree Completed: Degree Completed: Yes No Type of Degree: Major & Minor Studies: Other (Technical, Vocational, Military, Secretarial, etc.): Degree Completed: Degree Completed: Yes No Type of Degree: Major & Minor Studies: Please list professional memberships, certificates, licenses, honors, fellowships, etc: Please list professional memberships, certificates, licenses, honors, fellowships, etc References Please list two persons (other than relatives or former employers) who know your qualifications or who know your character.

**Reference 1**

Name: Address: City, State, Zip: Daytime Phone: **Reference 2**

Name: Address: City, State, Zip: Daytime Phone: Position Duties: Position Duties: Position Duties: Use the space below for any special qualifications and skills (i.e. skills with construction or office equipment, publications, etc.) or additional information that you feel will help us to evaluate your application: The statements made by me on this application are true and complete to the best of my knowledge. I understand that any willful misstatements or material omissions on this application will be considered sufficient cause to disqualify me from employment with The Jefferson Hotel. If such statements or omissions are found after employment, it will be considered grounds for dismissal. I authorize the release of any job-related information that The Jefferson Hotel may request from the above sources.

Date* Signature*