HISTORIC DENVER, INC. 1420 Ogden Street, Denver, CO 80218 Application for Employment PLEASE PRINT PERSONAL Name: ____________________________________________________ Date: _________________________ Address: ___________________________________________________ City: ___________________________ State: _______ Zip Code: _____ Phone Number: (______) ________________________ Position desired? ___________________________ Can you perform the essential functions of the position for which you are applying? YES NO If no, please explain. (If you have any question as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this question) _________________________________________________________________________________________ When would you be available to begin work? ____________________________________________________ Are you legally eligible to be employed in the United States? YES NO (Proof of identity and eligibility will be required upon employment) Are you over the age of 18 years? YES NO (If no, you may be required to provide authorization to work.) Have you ever worked under another name? YES for the change? NO If yes, what was it and what was the reason Have you ever been terminated by an employer? YES reason for being terminated. Have you ever been evicted? YES Have you ever filed for bankruptcy? NO If yes, please describe the situation and NO YES NO Have you ever been convicted of a crime or violation other than a minor traffic infraction? YES NO If yes, please explain: (A conviction will not necessarily result in the denial of employment.) _________________________________________________________________________________________ Please indicate the days and hours you are available to work: _________________________________________________________________________________________ Page 1 Are you presently employed? YES NO If yes, may we contact your employer? YES NO If presently employed, why are you considering leaving? _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ BUSINESS REFERENCES Name (Do not list relatives or friends) Occupation How Do You Know This Person? Telephone Number Name Occupation How Do You Know This Person? Telephone Number IMPORTANT, PLEASE READ AND SIGN I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this Application for Employment can be grounds for termination from the company or its' subsidiaries. I understand that if I am hired, my employment is for no definite time and may be terminated at any time without prior notice. By my signature I hereby authorize Historic Denver, Inc. to obtain credit and/or criminal background information on me for purposes of pre-employment screening. Signed: ____________________________________________________________________ Page 2