Employment Application

Personal Information

Last Name:

First Name:

Middle Name:

Street Address:

City, State, Zip:

Home Telephone:

Cell Number:

Email:

Have you ever applied for employment with us?

Year:

Job applied for:

Position Desired:

Pay Expected:

Apart from absence for religious observance, are you available to work any day of the week?

What hours/days are you not available?

Are you willing and able to work overtime if asked?

Are you legally eligible for employment in the United States?

Available start date:

Other special training or skills (Languages, machines operation, etc.), CPR or First Aid Certi ed, or Certi ed Lifeguard.

Education

College

Name and Location

Course of Study

No. Years completed

Did you graduate?

Degree or Diploma

Business/Trade School

Name and Location

Course of Study

No. Years completed

Did you graduate?

Degree or Diploma

High School

Name and Location

Course of Study

No. Years completed

Did you graduate?

Degree or Diploma

Membersip/Particioation in Professional or Civic Organization

You may exclude those which may disclose your race, color, religion or national origin.

Employment History #1

Company Name:

Phone Number:

Address:

Dates of Employment

From

Name of Supervisor:

Pay History

Starting

Last

State Job Title and Describe Your Work:

Reason for Leaving:

May we contact your current employer?

May we contact your previous employer?

Employment History #2

Company Name:

Phone Number:

Address:

Dates of Employment

From

Name of Supervisor:

Pay History

Starting

Last

State Job Title and Describe Your Work:

Reason for Leaving:

May we contact your current employer?

May we contact your previous employer?

Employment History #3

Company Name:

Address:

Dates of Employment

From

Name of Supervisor:

Pay History

Starting

Last

Reason for Leaving:

State Job Title and Describe Your Work:

May we contact your current employer?

May we contact your previous employer?

Military

Did you serve in the U.S. Armed Forces?

If “Yes,” in what Branch?

Describe any training received relevant to the position for which you are applying.

Other Information

How did you hear about this opening?

Have you ever been bonded?

If “Yes,” with what employers?

Employment status desired

Have you been convicted of a felony in the past seven years, which has not been annulled, expunged or sealed by a court?

If so, please list the date and state of convictions. Do not list any pending charges or misdemeanor convictions.

Please list the names of relatives of friends working for us, including your relationship.

References

Reference Name & Contact Information

Relationship

Reference Name & Contact Information

Relationship

Reference Name & Contact Information

Relationship

Signature

Misrepresentation or omission of facts will result in elimination from consideration for employment or termination if employed. The employment process includes a background investigation, veri cation of authorization to work in the United States, and a drug screen test. Any employment offer is contingent on the satisfactory result of all these inquiries.

I hereby authorize the Westwood Club to verify the information on this employment application. I also authorize and request each previous employer (current employer will be not be contacted unless permission is granted on page 2), or other persons given by me as a reference to answer all questions asked and to give any information sought in connection with this application, my work, character habits, skills or other relevant facts.

I have read and full understood the stipulation of this employment application.

* Signature:

* Date:

Employment History

Prospective employees will receive consideration without regard to race, color, religion, sex, age, national origin, disability, Vietnam era or disabled Veteran status. The Westwood Club is a drug free workplace.

* Denotes Required Field

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