EmailMe Form - America's Keswick Employment Application

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Telephone

### - ### - ####

Cell/Other Phone

### - ### - ####

Email

Position applying for

If you are under 18 and it is required, can you furnish a work permit?

If no, please explain.

Have you submitted an application here before?

If yes, give date(s) and position(s).

Have you ever been employed here before?

Date you started working at Keswick

MM / YYYY

Date of termination from Keswick

MM / YYYY

Are you lawfully authorized to work in the United States?

Date you are available to start working:

DD / MM / YYYY

Hourly or Salary Amount Desired

Is the above rate per hour or year?

Type of employment desired:

Will you travel if the job requires it?

Are you able to perform the "essential functions" of the job for which you are applying (with or without reasonable accommodation)?

This question is not designed to elicit information about an applicant's disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.

Driver's license number required if driving may be required in the job for which you are applying:

Driver's license state:

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