Abe's Employment Application Form

Employment Application

Contact Info

Abe's Motel and Fly Shop

P.O. Box 6428
Navajo Dam, NM 87419

Phone: 505-632-2194

email: abes1958@earthlink.net

We consider applications for all positions based upon qualifications without regard to sex, race, color, religion, national origin, age disability or veteran status, or any other basis protected by law.

Please complete all requested information. Failure to provide the information requested may result in your application being declined. You may email a resume; however, a resume will not be accepted in lieu of this form. If you require assistance to participate in the application/interview process, please indicate your requested accommodation below.

General Information
Last Name	First Name	Middle Name
Street Address	City	State	Zip code
Telephone Number(s) including area code Home Number	Message Number	Email
Positions Applied For	Wage Expected	Date of Application	Date Available
Can you with or without a reasonable accommodation perform the essential functions of the job for which you are applying? Yes

Availability Full Time: Part Time: Day Shift: Evening Shift:
Are there any days or hours that you are unable to work? If yes, please explain:
Abe's Motel and Fly Shop Inc., requires that Sales Associates selling alcoholic beverages meet the minimum age requirement for New Mexico of 19. Do you meet the minimum age requirement to sell alcoholic beverages? Yes
If you are under 18 years of age, can you provide proof of your eligibility to work? Yes
Are you legally entitled to work in the United States? (Proof of eligibility will be required upon employment) Yes
Do you have access to reliable transportation? Yes
Have you ever filed an application with Abe's before? If yes, provide date. Yes Date:
Have you ever worked for Abe's. If yes, when? Yes Date Info:
Do you have any relatives working for Abe's? If Yes, provide Names. Yes Names:
Have you been convicted of a felony within the last 7 years? If Yes, please explain. (Conviction will not necessarily disqualify an applicant from employment). Yes Explanation:

Employment History
How many jobs have you had in the last 7 years?
Have you ever been involuntarily discharged from employment? (If Yes, please explain) Yes Explanation:
Current/Most Recent Employer
Current/Most Recent Employer: City and State: Phone: Dates of Employment: Position: Pay Rate: Supervisor Name: Describe your duties: Reason for leaving: Please explain any gaps in employment:
Prior Employer
Prior Employer: City and State: Phone: Dates of Employment: Position: Pay Rate: Supervisor Name: Describe your duties: Reason for leaving: Please explain any gaps in employment:
Prior Employer
Prior Employer: City and State: Phone: Dates of Employment: Position: Pay Rate: Supervisor Name: Describe your duties: Reason for leaving: Please explain any gaps in employment:
Additional Experience / Other Training / Special Skills
Do you have any experience with the following (please check all that apply). Cash Register 10-Key Computer Typing (If yes, enter WPM)
Describe any other experience, qualifications, or skills that you feel would help you perform the job for which you are applying.
Education
High School : Course of Study: Year Completed: Did you Graduate? Yes Degree:
College : Course of Study: Year Completed: Did you Graduate? Yes Degree:
Business/Trade: Course of Study: Year Completed: Did you Graduate? Yes Degree:
Other : Course of Study: Year Completed: Did you Graduate? Yes Degree:
Military
Branch of Service: Date Entered: Date Discharged: Rank at Discharge: Reason for Discharge: Present draft, reserve or military status: Duties Performed / Special Training / Honors Received:
References
Give names, addresses and telephone numbers of three references who are not related to you and are not previous supervisors 1. 2. 3.
Applicant Statement
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all employment references and statements contained in this application of employment. I hereby understand and acknowledge that any employment relationship with this organization is of an "at will" nature and that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause or notice. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by the President of the organization. In the event of employment, I understand that incomplete, false or misleading information given in my application or interview(s) may result in discharge. I understand also that I am required to abide by all policies, procedures, rules and regulations of the Employer.