Hands On @Hyatt - Hands On Education

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Name

First

Middle

Last

SS#

Age

Date of Birth:

Place of Birth

Gender

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

List any accommodations that you may need to participate in this training:

Emergency Contact

Relationship to you:

Emergency's Phone

Emergency's Email

Date available to begin training:

*Class dates will be assigned on a first come – first served basis and you will receive a confirmation by mail or phoneinforming you of the class date you are assigned and other instructions, i.e.: directions, reporting times and places, etc.Due to small class size, there may by a waiting list of up to several months.

Department of choice*: (Select first, second, and third choice)

• Culinary	• Banquet Set-Up
• Housekeeping	• Engineering / Maintenance
• Laundry	• Receiving / Storeroom Clerk
• PBX Operation	• Cafeteria Attendant
• Guest Services

First Choice:

Second Choice:

Third Choice:

*Hands On Education cannot guarantee training in your preferred department. Department placing is based on interestof applicant and needs of the Hyatt hotel. If training in Tampa, Florida, Culinary is the only department open for training.

VR Counselor Information

Counselor’s Name:

Counselor’s Phone #:

Counselor’s Mailing Address:

Address Line 1

Address Line 2

City

State

Zip Code

Shirt Size (Mens Sizes)

*Uniforms are provided while you are in training only. **Please note that uniforms are only available in men’s sizes. Take this into account when selecting anappropriate size.

Which category or categories best describe(s) you: (Select ALL boxes that apply)

*This information is used for further verification when conducting a background check.

Are you a citizen of the United States?

Attach copies of Drivers License, SS Card, and Work Permit (if applicable)

Click or drag files to this area to upload. You can upload up to 3 files.

Have you ever been convicted of a felony?

Do you have any limitations that prohibit you from performing certain tasks?

Education

High School:

City:

Graduation Date:

Highest grade completed in school:

High School diploma is not required

Strongest School Subject:

Weakest School Subject:

Please list any degrees and / or certificates you have obtained:

College / Vo-Tech

Degree / Certificate Earned

Date

Single Line Text

Employment Interests

Please list three places of employment, located near your home, that you would like to work. It is not necessary to apply until you complete the training program.

Company:

Phone

Address:

Company:

Phone

Address:

Company:

Phone

in apply) Layout

Address:

References

Please list three references. If you have been employed, include at least one employment reference. If not, you may use a teacher or instructor.

Name

Relationship

Phone

Name

Relationship

Phone

Name

Relationship

Phone

Accommodations and Medical Questionnaire

Section A

I am in good health, take no prescription medications, and require no special assistance or equipment in order to complete the vocational training program.
I do take prescription medications or require special assistance or equipment in order to complete the vocational training program. (Please explain in section B)

Section B

4. List any food or medication allergies you may have. Please describe reactions.

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5. List any physical limitations you may have. (Heavy lifting, prolonged standing, etc)

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6. List any other concerns or issues that we can assist you with while enrolled in this trainingprogram.

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Applicant Statement

Please state in your own words, why you are applying for enrollment in this training program. Tell us a little more about yourself and what your goals are regarding employment.

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Please list any questions you may wish to ask the Program Director. This will help you organize your thoughts so you don’t forget to address a specific concern or issue.

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Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application could result in dismissal from the program and any employment connected with Hands On Educational Services. I also understand that I may be required to complete and pass a drug screening prior to starting employment and that a criminal history check will be conducted using the information that I have provided.

Print Name

Signature

Clear Signature

Date

Equal Opportunity Statement

Hands On Educational Services, Inc. is an equal opportunity training / placement service
and does not discriminate against any persons regardless of race, sex, sexual orientation, disability, nationality, religious beliefs, or ethnic background.

IMPORTANT – A $35.00 Non-Refundable application fee is required prior to applications being processed. Class slots are on a first come-first serve basis and Hands On Educational Services cannot confirm an enrollment date until this fee has been received by our office.

IF YOU EMAIL THIS FORM YOU STILL MUST MAIL APPLICATION FEE AND COPIES OF DRIVERS LICENSE, SS CARD, AND WORK PERMIT (IF APPLICABLE) TO THE ADDRESS BELOW:

Hands On Educational Services, Inc.
P.O. Box 261987
Tampa, FL 33685-1987

Note to VR Counselors: You will be emailed an application fee invoice upon receipt of client application.