Today's Date

Name (First, M.I.,Last)

Social Security #

Email Address

Mailing Address (Number, Street, City, State, Zip)

Phone # (Area Code)

Cell # (Area Code)

High School, City, State

Did you Graduate?

Additional Education


Did you Graduate?

How did you hear about the position?

Ever applied to work at or worked at the Capital Hotel before? When?

Please list any other names you have used (maiden,etc.)

Have you ever been convicted of a felony? If yes, please explain?

Have you ever been convicted of a misdemeanor or drug related offense involving fraud, false statements or omissions, wrongful taking of property or forgery? If yes, please explain.

Is there anything which would prevent you from performing all of the essential functions of this job?

Briefly state why you want to work for the Capital Hotel:

WORK HISTORY - Account for



Company Name, Address, Zip Code

Supervisor’s Name Phone Number


Reason for Leaving

Valid driver’s license?


Exp. Date

Driver License #

License ever suspended or revoked? If yes, explain:

Driver’s License Information
Job Information

For what job are you applying?

Date available for work: Is there any time that you are unable to work? If yes, state when:

What are your wage or salary requirements?

Type of employment desired (FT/PT):

Can you travel if the job requires it?

Do you have the legal right to work in the US?

Are you of legal age to work?

Are you at least 21 or older in order to serve alcohol?

References (Be sure that phone

Full Name

Years Known


Daytime Phone Number

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No, I Disagree with the Employment at Will terms
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Capital Hotel | Markham & Louisiana, Little Rock, Arkansas 72201 | 501-370-7090 |

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