River Road North
Wisconsin Dells, WI 53965
(608) 254-8366 or (800) 388-4782
(608) 254-7653 (fax)

Employment Information
Date Of Application:
Position (s) Applied for:

How did you hear about us:
First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone Number:
Social Security:
How were you referred to Chula Vista for Employment?
Advertisement (newspaper) Current Employee, Friend or
Job Service or Job Fair ......Relative, Please List:
Chula Vista Website ....
Temporary Staffing Agency Wisconsin Job Net
Radio Advertisement College Recruitment Fair / Conf.
Governmental Agency Other
If you are currently employed, may we contact you at work? Yes No
If Yes, please enter your work number & best time to contact you at work:
Have you ever applied at Chula Vista before? No Yes (give date and location)
If hired, what date would you be able to start work?
Type of employment desired: Day Shift Night Shift 3rd Shift

Permanent
Temporary
Full Time
Year Round
Part Time
Seasonal / Summer
Are you a U.S. citizen or otherwise legally entitled to work in the U.S.? Yes No
Have you been convicted of a felony within the last 7 years? Yes No
If yes please explain:
 
Employment History:
Please list your last three employers, starting with the most recent.
You may include past military experience.

Starting Date:
Ending Date:
Name of Employer

Telephone:
Job Title:
Address:
Supervisor & Title:

Job Responsibilities:

Starting Pay Rate:
Reason For Leaving:
Ending Pay Rate:
May We Contact? Yes No

Starting Date:
Ending Date:
Name of Employer

Telephone:
Job Title:
Address:
Supervisor & Title:

Job Responsibilities:

Starting Pay Rate:
Reason For Leaving:
Ending Pay Rate:
May We Contact? Yes No

Starting Date:
Ending Date:
Name of Employer

Telephone:
Job Title:
Address:
Supervisor & Title:

Job Responsibilities:

Starting Pay Rate:
Reason For Leaving:
Ending Pay Rate:
May We Contact? Yes No
Please list or explain gaps in your employment history:
Please list or explain gaps in your employment history:
 
Educational Background

Name of School:
Years
Course of Study
Graduate?
Diploma and Year
Yes No
Yes No

Yes No
Yes No
Refrences (please list three)
References should be individuals who have not been previous supervisors or related to you.

Name
Phone
Current Address
Occupation
How long you have known them?

Name
Phone
Current Address
Occupation
How long you have known them?

Name
Phone
Current Address
Occupation
How long you have known them?

Chula Vista Resort is an equal opportunity employer. No question is asked to exclude any applicant regarding race, creed, color, national origin, religion, age, sex, disability, veteran status, sexual orientation, disability or any other bases declared unlawful by state or federal laws.

I understand that any misrepresentation of the information I have provided will be sufficient cause for cancellation of this application and termination of my employment if hired by Chula Vista Resort. I give Chula Vista Resort the right to inquire on all refrences and secure information about me if it is job related and hereby release the employer (Chula Vista Resort) and its representatives for seeking the information and all other person, corporations, or organization for furnishing this information. I understand that this application will be considered active for a period of only 60 days from the date of application. At the end of that time, I understand that if I have not heard from Chula Vista Resort, it will be necessary to complete a new application.

Chula Vista Resort is an “at-will” employer, and I understand that I am free to resign or terminate my employment with Chula Vista Resort, and that the employer (Chula Vista Resort) has the right to terminate my employment with or without cause, reason, and without prior notice at any time. I understand that no representative of the employer has the authority to make assurances to the contrary.