CLUBHOUSE 81 - Application For Employment
Pre-Employment Questionnaire - Equal Opportunity Employer
Name *
(Last Name First)
Your answer
Position Desired *
Your answer
Phone Number *
Your answer
Present Address *
Your answer
Desired Pay *
Your answer
Date You Can Start *
MM
/
DD
/
YYYY
Are You Currently Employed? *
Required
If Yes, May We Inquire Of Your Present Employer? *
Required
Education History *
Please Include High School, College, And Any Trade School
Your answer
General Information *
Please List Any Special Skills or Training Here
Your answer
Former Employers *
Please List At Least One Former Employer, Include Month and Year of Employment Term, Along With Salary and Reason For Leaving.
Your answer
Former Employers
Include Month and Year of Employment Term.
Your answer
Former Employers
Include Month and Year of Employment Term.
Your answer
References *
Please list 3 persons not related to you, whom you have known at least one year.
Your answer
Authorization - Please Type Your Name Below. *
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities act (ADA) and other relevant federal and state laws. I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such records are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document upon hire.
Your answer
Authorization Date *
MM
/
DD
/
YYYY
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