PERSONNEL APPLICATION

Please Print Neatly and Complete All Blanks on Both Sides

Name                                                                                                                                                            

                   Last                                                             First                                                 Middle

Permanent Address                                                                                                                                     

   City/State/Zip                                                                                 Telephone (             )                             

Summer Address                                                                                                                                          

City/State/Zip                                                                                 Telephone (             )                             

Social Security #                              -                    -                            Birth Date              /             /           

Emergency Contact                                                                                                                                                          ________             Name                   Address                                         Phone                                              Relationship

 Position(s) Applying For                                                                                                                                 

Seasonal Availability:  Start Date                                                  End Date                                                  

Salary Desired:                                                  Referred by:                                                                      

FORMER EMPLOYERS:  (List below your previous employers, starting with the most recent)

Month            Name/Address                                                                                                                Reason

& Year            of Employer                              Salary                                 Position                           for Leaving      

From

To                                                                                                                                                                                                                                         

From

To                                                                                                                                                                                                                                         

From

To                                                                                                                                                                                                                                          

From

To                                                                                                                                                                                                                                          

From         

To                                                                                                                                                                                                                                          

Page 1 of 2

                                                                                                                                                                                                    Page 2

REFERENCES:

Name                           Address                     Business                      Phone                                  Relationship     

                                                                          ___________                                                                                   

EDUCATION:  (Please list your educational background.)

SPECIAL SKILLS/TRAINING:

GENERAL INFORMATION:

I certify that all the information submitted by me on this application is true and complete and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.  In consideration of my employment, I agree to conform to the company’s rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time.  I understand that work at the Cape Playhouse is seasonal in nature and that, if hired, it will be for a finite period of time.

Date:                                                                Applicant Signature: