COUNTRY INN ONLINE APPLICATION
First Name
*
Middle Int.
*
Last Name
*
Street Address
*
City
State
*
- - Choose One - -
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone No.
*
Refered By
Desired Position
*
___Choose One___
Food Server
Cook
Dish Washer
Hostess
Date You Can Start
*
Desired Pay
Are you employed now?
*
Yes
No
May we contact your current employer?
Yes
No
Are you legally authorized to work in the US
*
Yes
No
Education History
High School
*
Years Attended
Did you Graduate?
*
***Select One***
Yes
No
College or Trade School
Special Training
Special Skills
Military or Naval service
*
***Select One***
YES
NO
Rank
Former Employers: Name, Address, Positoin, Dates, Reason for leaving
*
Former Employers: Name, Address, Positoin, Dates, Reason for leaving
Former Employers: Name, Address, Positoin, Dates, Reason for leaving
Former Employers: Name, Address, Positoin, Dates, Reason for leaving