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 Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe 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 SUN MON TUE WED THU FRI SAT Times Add Remove Highest Year Completed Section High School 9th Grade 10th Grade 11th Grade 12th 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 Add 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 upload 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