Position Sought:
How did you learn about position:
Name:
 Home Phone:
Address:
 Work Phone:
City:
 Cell Phone:
State:
 Zip:
 Email address:
Desired Wage:
 Drivers License #:
Date available for work:
 State Issued:
Are you a U.S. citizen, or are you
otherwise authorized to work in the
U.S. without any restriction?
Have you ever been convicted of a
felony?
 If YES, please describe circumstances:
Have you ever been involuntarily
terminated or asked to resign from any
position of employment?
 If YES, please describe circumstances:
If selected for employment, are you
willing to submit to a pre-employment
drug screening test?
EDUCATION
School Name and Location
 Years Attended
 Degree Received
Other training, certifications, or licenses held:
List other information pertinent to the employment you are seeking:
EMPLOYMENT
1. Employer:
 Job Title:
Dates Employed:
 Address:
City:
 State:
 Zip:
 Supervisor:
Supervisor Phone:
 Starting Wage:
 Ending Wage:
Duties Performed:
Reason for Leaving:
2. Employer:
 Job Title:
Dates Employed:
 Address:
City:
 State:
 Zip:
 Supervisor:
Supervisor Phone:
 Starting Wage:
 Ending Wage:
Duties Performed:
Reason for Leaving:
ACKNOWLEDGEMENT AND AUTHORIZATION
I certify that answers given herein are true and complete to the best of my knowledge.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving
at an employment decision. I understand that additional information may need to be provided prior to an employment
decision.

This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant
wishing to be considered for employment beyond this time period should inquire as to whether or not applications are
being accepted at that time.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship
with this organization is of an "at will" nature, which means that the Employee may resign at any time and Capitol
Lakes Property Services, LLC may discharge Employee at any time with or without cause. 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 an authorized executive of this organization.

In the event of employment, I understand that 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 rules and regulations of the employer.
I have read and understand the above paragraphs.
Capitol Lakes Property Services, LLC does not discriminate against employees and job applicants because of their:

• Sex • Use of Lawful Products • Color • Arrest or Conviction • Ancestry • Honesty Testing • Disability • National
Origin • Marital Status • Pregnancy or Childbirth • Race • Sexual orientation • Creed (Religion) • Genetic Testing •
Age (40 or Over) • Military Service Membership
APPLICATION FOR EMPLOYMENT