Test Form Personal Information Have you ever applied or been employed by this company? ---YesNo If Yes: Are any of your relatives currently employed by this company? ---YesNo If Yes: If hired, can you provide proof that you are eligible to work in the United States? ---YesNo Are you at Least 18 years old? ---YesNo If not, do you have a work permit? ---YesNo Have you ever been convicted of a crime? ---YesNo If Yes: Employment Desired Applying for: ---Full TimePart Time If Part Time: Are you willing to work overtime as required? ---YesNo Nights? ---YesNo Weekends? ---YesNo Holidays? ---YesNo If hired would you be willing to commit to work with us for at least 9 months? ---YesNo Education *Please omit any information that would disclose race, age, ethnic origin, handicap status, or sexual, religious, or political persuasion. High School College/University Other Education Skills and Memberships If job related, indicate the kinds of work which you have done: TypingComputersWord ProcessingOther References Give the name of 3 persons not related to you, whom you have known at least one year. How Were You Referred to Us? EmployeeState or Local AgencyInternetNewspaper AdEmployment AgencyOther In case of Emergency, please notify: Work Experience Please note: If you were known by another name at a previous place of employment, please state the other name and date of use. Other Information If you have dependent children, has child care been arranged? ---YesNo Do you have reliable transportation? ---YesNo Do you use tobacco? ---YesNo Do you drink alcoholic beverages? ---YesNo Do you use narcotics or any illegal drugs? ---YesNo How many days per week would you like to work? Are there any days that you cannot work? ---YesNo Please indicate your reason for applying for employment. Wish to change employmentHave experience in the lodging industryUnemployedOther Are you currently working any other job that you plan to keep? ---YesNo Front Desk Positions: Check all shifts you are willing to work 7:00 AM - 3:00 PM3:00 PM - 11:00 PM11:00 PM - 7:00 AM Housekeeping Positions: Do you have any back or knee injuries that will hinder your ability to perform typical housekeeping duties? YesNo Certification of Agreement By entering the date and my name below, I certify that all information on this application is true and correct. I also certify that I have accounted for all of my work experience and training on this application. It is my understanding that Quality Inn & Suites may make a thorough investigation of my entire work and personal history and may verify all data given in my application for employment, related papers, or oral interviews. I authorize such investigation and the giving and receiving of any information requested Quality Inn & Suites and I release from liability any person giving or receiving.