Cuffy's of Cape Cod

Cuffy's
Human Resource Department
1 Reardon Circle
South Yarmouth, MA 02664
508-394-1371 x210 nbrian@cuffys.com

EMPLOYMENT APPLICATION
Please e-mail application or print, sign, and mail application to the address above.

Personal Information

Job Request #

Your e-mail address:

First & Last Name:

Address 1:

City:

Phone (local):

() - Number

Position Applying For:

First Name:

Address 2:

State:

Zip:

Phone (Permanent):

() -

Employment History

Employer #1
(present or most recent):

State:

City:

Job Title/Duties:
Supervisors name:
Salary:
Reason for leaving:

Employed:

From: To:

Employer Phone Number

() -

Employer #2
(present or most recent):

State:

City:

Job Title/Duties:
Supervisors name:
Salary:
Reason for leaving:

Employed:

From: To:

Employer Phone Number

() -

Employer #3
(present or most recent):

State:

City:

Job Title/Duties:
Supervisors name:
Salary:
Reason for leaving:

Employed:

From: To:

Employer Phone Number

() -

Education
(check all that apply)

High School or Equivalent:

Yes No

Graduate/
Professional School:

Yes No

Type of Degree:

MA		MS
MBA		PhD
MD		JD

College/Business/
Trade School:

Yes No

Type of Degree:
AA AS
BA BS

Please answer the following questions:

Why are you applying at
Cuffy's?

Please indicate days and
hours you are available.

Are you 18 years or older?

YesNo

What special qualifications
or training do you have?

Do you wish full time
or part time employment?

Full timePart time

If you are a summer
employee, on what date
will you be leaving?

What location do you
wish to work at?

Would you be willing to
work overtime?

YesNo

When can you start work?

In case of emergency
notify
(include phone number)

PLEASE READ THOROUGHLY AND THEN SUBMIT

I authorize Cuffy's to investigate any of my previous records of employment and to obtain all information which may concern previous employers and thus release my former employers of any liability for any damage in the event of furnishing such information. I understand that any misleading or incorrect information, misrepresentation, or ommission of necessary facts may render this application void or may be cause for immediate dismissal and that the issuance of this application does not necessarily indicate that there are any positions open at present.
I certify that the statements made on this applications are true, complete, and correct to the best of my knowledge and such statements may be investigated. I further agree to abide by the rules and policies of Cuffy's. I also understand that the completion of this application will in no way insure that I will be employed or granted an interview. I understand that if I am employed by Cuffy's, my employment is for no definite term and that I can be terminated at any time without notice and without cause. I further understand that no verbal promises or guarantees are binding on Cuffy's and that no one, other than the President of Cuffy's, has the authority to enter into an agreement for employment contrary to the above, and that any agreement must be in writing. If employed, I agree to abide by all of Cuffy's rules and regulations and any changes thereto.

*If you agree to the terms and conditions above, please enter your e-mail address and press "Submit Application".

I agree to the terms and conditions above. (Type yes if submitting electronically)

Sign and date (if mailed)

The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to persons
who are at least 40 but less than 70 years of age. It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and/or civil liability.