Employment Application “WE ARE ALWAYS ACCEPTING APPLICATIONS” Job Opportunities are the following: Party Host/Hostesses Security Supervisor Cashier Pizza Cook Cafe Cook Ride Operators Bar Waitress Please fill out the below application to apply for a position - Step 1 of 5Personal InformationName *FirstLastAddress *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePrimary Phone *Alternate PhoneHave you ever applied or been employed with us? *NoYesPreferred email addressName UsedMonth & YearLocationPosition DesiredPay ExpectedAre you legally eligible for employment in the United States? *YesNoIf hired, can you provide verification of your legal right to work in the US? *YesNoWill you work overtime if asked? *YesNoWhen will you be available to begin work? *Are you 18 years of age or older? *YesNoDo you have a valid work permit?YesNoOther special training or skills (computer, machine operation, etc.)Foreign language(s) spoken fluently which would be helpful in position sought:How did you hear of our organization?Have you ever been dismissed or asked to resign from a job?YesNoPlease explainHave you used any other names under which employment or education may be verified?YesNoPlease explainAre any of your relatives currently working within this company?YesNoName(s) and Location(s)NextEducationDid you go to, or are you currently attending, college?YesNoName and Location of CollegeCourse of studyNo. of years completedDid you graduate?YesNoList degree or diplomaDid you go to, or are you currently attending, High School?YesNoName and Location of High SchoolCourse of studyNo. of years completedDid you graduate?YesNoList degree or diplomaAny other education?YesNoName and Location of SchoolCourse of studyNo. of years completedDid you graduate?YesNoList degree or diplomaNextMilitaryComplete this section if you served in the U.S. Armed ForcesDescribe your duties and any special trainingBranch of ServicePeriod of Active Duty From/To (Month & Year)Rank at DischargeNextEmployment (Please list your most recent 3 positions)Most Recent PositionCompany NamePhoneAddressStatusFull TimePart TimeName of SupervisorSupervisor's PhoneEmployment Date RangeFromMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ToMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920State Job Title & Describe Your WorkReason for LeavingMay We Contact This Employer?YesNoPlease tell us why you would prefer we don't contact this employer. 2nd Most Recent PositionCompany NamePhoneAddressStatusFull TimePart TimeName of SupervisorSupervisor's PhoneEmployment Date RangeFromMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ToMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920State Job Title & Describe Your WorkReason for LeavingMay We Contact This Employer?YesNoPlease tell us why you would prefer we don't contact this employer. 3rd Most Recent PositionCompany NamePhoneAddressStatusFull TimePart TimeName of SupervisorSupervisor's PhoneEmployment Date RangeFromMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920ToMM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920State Job Title & Describe Your WorkReason for LeavingMay We Contact This Employer?YesNoPlease tell us why you would prefer we don't contact this employer.NextAcknowledgments (Please read carefully. Check the box next to each paragraph to indicate your agreement)Acknowledgment 1 *I authorize any person, school, current employer (except as expressly noted), past employer(s), and organizations named in this application form (and accompanying resume or other documentation, if any) to provide Newport Diversified, Inc. with relevant information and opinion, personal or otherwise, that may be useful in making a hiring decision. I release all parties from all liability for any damage that may result from furnishing informatoin and opinion to you.Acknowledgment 2 *In consideration of employment, I agree to obey the rules and standards of Newport diversified, Inc. I understand that nothing in this application or in the interview process is intended to create a contract between the Company and myself for either employment or for the providing of any benefits. I agree that my employment is at-will and the terms of employment may be changed with or without cause, with or without notice, including but not limited to termination, demotion, promotion, transfer, compensation, benefits, duties and location of work, at any time, for any reason, at the option of myself or the Company. This consitutes my entire agree with Newport Diversified, Inc. with regard to the length of my employment.Acknowledgment 3 *I understand that as a condition of employment I may be required to take a post-offer/pre-employment physical examination which may include an alcohol and drug test. I further understand that at any time during my employment, I may be required to take a physical examination which may include an alcohol and drug test if management reasonably suspects a condition exists that may cause me to perform my job in a manner that may endanger my health or the safety and health of others. I authorize all providers of health care who examine me to disclose to the Company or its agents, all medical information revealed during such examinations. I further authorize Newport Diversified, Inc. to disclose such information to any other persons, if at any time my medical condition is put at issue in any proceeding by myself or others. In the event that I have a disability which will affect my ability to take the test, I will so inform the Company so that a reasonable accomodation can be made. Newport Diversified, Inc. reserves the right to require medical documentation concerning the need for accommodation.Acknowledgment 4 *I understand that all offers of employment are conditioned upon my providing satisfactory documentary proof of my identity and legal right to live and work in the United States.Acknowledgment 5 *I hereby acknowledge that I have read the above statements and understand them. I certifythat I, the undersigned applicant, have personally completed this application. I declare under penalty of perfury that the facts contained in the application (or any resume or other documents submitted) are true and complete to the best of my knowledge. I understand that any misrepresentations or omissions will disqualify me from further consideration for employment, and will be justification for my dismissal from employment, if discovered at a later date.Please attach your resume if you have oneEmailSubmit Application