Employment Application Personal Personal First Name * Last Name * Middle Name Other Name(s) Used Email Address * Home Telephone # Cell # Address * Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Position Section Position(s) Applying For Pay Rate Desired $ Date Available Referred By Availability Full-Time Part-Time On Call Temporary Have you ever interviewed with Kāhala Nui before? * Yes No Please list date(s) and job title(s) Have you ever been employed by Kāhala Nui before? * Yes No Please list date(s) and job title(s) If hired, can you prove you are a U.S. citizen or otherwise legally permitted to work in the United States? * Yes No Days & Times Available to Work Days & Times Available to Work Day SUNMONTUEWEDTHUFRISAT Times plus1 Add minus1 Remove Highest Year Completed Section High School 9th Grade10th Grade11th Grade12th Grade College, Trade or Business (1 yr., 2yrs, etc) Graduate Studies High School High School High School Name City / State Major Studies Degree, Diploma, License or Certificate College College College Name City / State Major Studies Degree, Diploma, License or Certificate Vocational, Business, Other Vocational, Business, Other Vocational, Business, Other City / State Major Studies Degree, Diploma, License or Certificate Other Special Knowledge, Skill or Qualifications Employment History Employment History Employed From Employed Until Employer Name Employer Address Supervisor Name & Title Supervisor Phone # Job Title Reason for Leaving Duties & Responsibilities plus1 Add minus1 Remove Section We may contact employers listed above unless you indicate those you do not want us to contact. Why are you interested in working at Kāhala Nui? List certifications, licensure, or memberships in professional and civic organizations, special accomplishments, awards, etc. (Exclude those which may disclose your race, color, religion, age or national origin) Resume Resume Upload Drop a PDF file here or click to upload Choose File Maximum file size: 5MB By signing below I verify that the information provided on this application and/or resume, and in any past or future interview, is true, correct and complete. I understand that in the event of my employment or offer of employment by Kāhala Nui, I shall be subject to dismissal or refusal of employment if any information that I have given is false, misleading or incomplete, regardless of the time elapsed after discovery. I authorize Kāhala Nui or its agent to contact and obtain information about me from previous employers, educational institutions and “references” that I have provided, and any other party necessary to verify the accuracy of information I have disclosed in this application, a related employment resume or a personal interview and hereby authorize such parties to provide Kāhala Nui or its agent with any relevant information that may be requested. I also hereby release all parties seeking and providing information from any and all liability or claims for damages whatsoever that may result from this information’s release, disclosure, maintenance or use. I also authorize the Company to provide truthful information concerning my employment with it to my future prospective employers and I agree to hold it harmless for providing such information. I understand that all Associates and prospective Associates of Kāhala Nui may be subject to drug testing through onsite oral fluid testing or lab analysis of urine samples. These tests include: pre-employment, random, post accident, return-to- duty and reasonable cause. In applying for employment, I understand that I may be required to undergo a physical examination and pre-work screen as a requirement of such employment. I understand that a positive test of drugs may result in a rejection from further consideration for employment by Kāhala Nui or a revocation of any conditional job offer. I also understand that if the drug screening test is positive, I will be confidentially notified of the results. I recognize that any falsification, misstatement or evasion made by me in connection with my physical examination and medical history or any other step in the pre-employment process will subject me to discharge any time after discovery. This application is not an employment agreement. If I accept an offer of employment I understand I may resign at any time, and the employer may terminate my employment at any time with or without cause and without prior notice, unless required by law. This application for employment will be considered active for a period of 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. Term Acceptance * I fully understand and accept all terms and conditions in the above statement. Submit
