Personal Information
Last Name
First
Name
Middle Name
Address
City
State
Zip
Phone
Are you at least 18?
yes
no
Are you a citizen of the U.S. or do you have the legal right to be employed in the United States?
yes
no
Have you ever been convicted of any crime (excluding minor traffic violations) including driving while under the influence of alcohol or drugs?
yes
no
If yes, state the offense, location, date, and disposition
NOTE: A conviction will not necessarily disqualify you from employment.
Do you have the ability, with or without reasonable accommodations, to work overtime or to travel if required by the job for which you are applying?
yes
no
If no, please explain
Drivers License:
State
Type (Class)
Currently Valid?
yes
no
Employment Desired
Are you seeking
full-time
part-time
temporary, summer, or holiday employment?
Position Applied for
*If you choose Golf or other please fill out the fields below.
Please choose...
Banquet Server
Chef
Dishwasher
Driver
Golf Division (specify)
Local Sales / Event Planning
Maintenance
Office Support / Accounting Dept
Other
Prep-Cook/Kitchen Help
Salary Desired
Have you ever applied to our company before?
yes
no
Have you ever worked for our company before?
yes
no
If your answer to either of the above questions is Yes, state when and where your applied and/or worked.
How did you learn of our company and/or position?
Education
Name, Address and Location
Dates
Graduate?
Courses Studied
High School
yes
no
Diploma:
College
From:
To:
yes
no
Diploma:
Trade School
From:
To:
yes
no
Diploma:
If you did not graduate, why did you leave high school or college?
Are you planning to pursue further studies?
yes
no
If so, when, where and what courses?
List and describe any other School or Specialized Training
Capability / Reliability
Would you be willing and able to perform all of the tasks required by the job you are applying for?
yes
no
If not, explain which tasks
Have you filed any type of fraudulent claim against any of your present or past employers?
yes
no
If yes, explain
Will you abide by the safety rules of this company?
yes
no
Have you ever been disciplined for violating company safety rules or regulations?
yes
no
If yes, please explain
How many days of work (or school) have you missed in the last two years?
Would you be willing and able to report to work on time every day on a regular and consistent basis?
yes
no
If no, please explain
What days and hours are you available for work?
Military
Have you ever served in the military?
Date Entered
Date Separated
Service Branch
yes
no
Work History
List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references
PLEASE PROVIDE MONTH AND YEAR DO NOT REFERENCE YOUR RESUME.
Employer 1
Supervisor
Employed (MM/YY)
Name of Employer
Address
City, State, Zip Code
(name/title)
From:
To:
Pay
Nature of Business
Telephone
Starting
Ending
Title
Reason for Leaving
Duties
May we Contact this Employer?
yes
no
If No, Please state why:
Employer 2
Supervisor
Employed (MM/YY)
Name of Employer
Address
City, State, Zip Code
(name/title)
From:
To:
Pay
Nature of Business
Telephone
Starting
Ending
Title
Reason for Leaving
Duties
May we Contact this Employer?
yes
no
If No, Please state why:
Employer 3
Supervisor
Employed (MM/YY)
Name of Employer
Address
City, State, Zip Code
(name/title)
From:
To:
Pay
Nature of Business
Telephone
Starting
Ending
Title
Reason for Leaving
Duties
May we Contact this Employer?
yes
no
If No, Please state why:
Supplimental Employment Information
Are you presently employed?
yes
no
If yes, may we contact your present employer?
yes
no
Have you ever been fired, or asked to resign, from a job?
yes
no
IF yes, please explain
Special Skills
Do you type?
yes
no
Words per Minute
Have you had any computer or word processing experience or training?
yes
no
If yes, please describe
What languages do you speak fluently?
Use this space below to describe why you are interested in working for our company and to list those skills and abilities which you feel particularly qualify you for a position with us.
References
I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever, I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this
application form or during any interviews may be grounds for my immediate discharge.
I hereby authorize the company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right to bring any cause of action against these individuals for defamation, invasion of privacy or any other reason because of their statements.
I agree that, if I am employed, I will abide by all the rules and regulations of the company. I understand that the taking of drug and alcohol tests, when given pursuant to company policy, are condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination. I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of the President of the company. I also understand that my employment is “at-will” and may be terminated by myself or by the company at any time for any reason or no reason at all, with or without prior notice.
I Agree
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