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Application for Employment

INSTRUCTION: Please fill out the application completely even if you send us a resume. Please be aware that applications can only be accepted for current openings. Qualified applicants will receive equal consideration. No question is asked for the purpose of excluding any applicant on the basis of race, color, national origin, religion, age, sex, disability, or any other factor prohibited by law or regulation. Boca Bargoons, Inc. (and its subsidiaries) is an equal opportunity employer.

To print a copy of this application, click here to download form and fax to: (239) 274-0393

PERSONAL INFORMATION

Date:

Full name:

(Last, First, MI)

Present address:

City:

State: Zip:

Day phone number:

Evening phone number:

Email address:

Referred by:

Location applying for:

Position applying for:

Date you can start:

Salary desired:

Are you currently employed?

Yes
No

If yes, may we inquire of
your present employer?

Yes
No

Have you ever applied
with Boca Bargoons?

Yes
No

AVAILABILITY FOR WORK

Type of work:

Full Time
Part Time
Temporary

Shift desired:

Day
Weekend only
Willing to work any

Will you work overtime during
the work week if necessary?

Yes
No

Do you have any on-going obligations or other personal commitments that would
affect your work schedule? Yes No
If Yes, please describe:

PERSONAL

If requested, would you be willing to take a drug/alcohol screening exam as a condition of employment?
Yes No

Are you at least 18 years old?
Yes No

Can you provtypee documented proof of U.S. Citizenship of, if an alien, proof of authorization to work in the United States?
Yes No

Have you ever been disciplined or terminated?
Yes No
If Yes, please explain:

Have you ever been convicted of any law violation, except a minor traffic violation?
(A criminal record does not automatically bar employment)
Yes No
If Yes, provtypee details:

EDUCATION AND TRAINING

	School Name City and State	# Years Attended	Did you Graduate?	Major subjects, special courses, degrees
High School
College or University
Graduate School
Other Education
Licenses & Certifications
Other Skills

EMPLOYMENT RECORD: DO NOT indicate " See Resume" .

Give a complete account of your employment, including salary history. Begin on the first line with your present or most recent position and work back. Please use the additional box if necessary and include all periods of unemployment.



Month/Yr Started	Name, Address, Phone of Employer	Starting Salary	Position/ Duties	Reason for Leaving
Month/Yr Ended		Ending Salary		Supervisor's Name & Title

What did you like about this job?			What did you dislike about this job?



Month/Yr Started	Name, Address, Phone of Employer	Starting Salary	Position/ Duties	Reason for Leaving
Month/Yr Ended		Ending Salary		Supervisor's Name and Title

What did you like about this job?			What did you dislike about this job?



Month/Yr Started	Name, Address, Phone of Employer	Starting Salary	Position/ Duties	Reason for Leaving
Month/Yr Ended		Ending Salary		Supervisor's Name and Title

What did you like about this job?			What did you dislike about this job?

Periods of Unemployment: (If applicable)

WORK REFERENCES: Please provtypee a minimum of three.

First Name, Last Name	Company and Title	Relationship to you	Phone Number

PERSONAL REFERENCES: Please provtypee a minimum of two people who are not related to you.

First Name, Last Name	Company and Title	Relationship to you	Phone Number

CERTIFICANT OF APPLICANT (Read carefully before submitting)

All information provided by me is true and correct to the best of my knowledge. I understand omissions or misrepresentations may result in rejection of my application or if employed, may result in subsequent dismissal. I hereby authorize all former employers, educational institutions, personal references and others typeentified here on, including their employees or representatives, to furnish or provtypee full and complete reports, documents or information to Boca Bargoons, Inc., its Subsidiaries or affiliate companies, employees and representatives and all other persons or entities from all liability and all claims of any nature whatsoever pertaining to the disclosure or use of information or written material as described above. I understand this is a preliminary application and not a contract to employ me. Furthermore, in the event I am employed, my employment shall be completely voluntary and may be terminated at will at any time by either myself or the company. I understand that any employment agreement to the contrary must be in writing and approved by the Company's President or Vice President. If employed, I agree to comply with all rules of the company as a condition or continued employment.

DATE:

DIGITIAL SIGNATURE OF APPLICANT:

By clicking 'Submit Application' you are agreeing to the terms stated above.