Huron Mountain Club Keeper Application 2019
NOTICE: The Huron Mountain Club does not employ keepers. Keepers are employed by individual families of members or guests of the Club. This application is intended to provide important information about you in order to assist the member or guest in making the hiring decision.
Background information
Name (ex. Last, First): *
Your answer
Email: *
Your answer
Phone number (ex. 555-555-5555): *
Your answer
Dates you are available (ex. July 1 - August 31): *
Your answer
Have you ever worked at the Huron Mountain Club? *
If you responded yes to the above question, who did you work for and when (ex. Gates/Summer 2016)?
Your answer
Dates and names of families you are already scheduled with for 2019 (ex. Smith/July 1 - August 1):
Your answer
Check all of the age groups you feel comfortable working with. *
Required
Are you 18 or older? *
Are you a U.S. citizen? *
Can you swim? *
Who were you referred by?
Your answer
Have you ever been convicted of a crime? *
If yes, please explain:
Your answer
What is your home address (ex. street, city, state, zip code): *
Your answer
Employment History
If you have not yet worked as a keeper, please list below the last three employers you've had, starting with the most recent. Be sure to fill in all parts including the name of the employer, your supervisor's full name, a contact number for the employer, how long you were employed, and your reason for leaving.
Employer #1, supervisor's name, contact number, length of employment, reason for leaving:
Your answer
Employer #2, supervisor's name, contact number, length of employment, reason for leaving:
Your answer
Employer #3, supervisor's name, contact number, length of employment, reason for leaving:
Your answer
Education History
Please fill in the details of your education history
High school name: *
Your answer
Did you graduate from high school? *
College name:
Your answer
Number of years or degree earned:
Your answer
Field of study
Your answer
Outdoor Activities Program Information
Why do you want to work as a keeper at the Huron Mountain Club?
Your answer
Describe any experience you have in working with children under the age of 12.
Your answer
Describe any special skills or talents you can offer the Outdoor Activities Progam.
Your answer
References
List 3 people not related to you who you have known for at least one year. Please list name, years acquainted and phone.
Reference #1 name, years acquainted, phone number *
Your answer
Reference #2 name, years acquainted, phone number
Your answer
Reference #3 name, years acquainted, phone number
Your answer
Legal agreement
By signing this form I am authorizing the Huron Mountain Club to complete or have completed a background check including a criminal history and/or driving record, as required. I certify that the facts contained in this application are true and complete to the best of my knowledge, and I understand that, if employed, any false statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained in this application, and I authorize any employer or reference listed herein to give you any and all information concerning my previous employment and any parties from any liability for damage that may result from furnishing the same to you. I understand that, if hired, my employment is for no definite period and may, regardless of the frequency of payment of my wages or salary, be terminated at any time without cause and without prior notice. I also understand that the above terms may only be modified in writing signed by the President of the Huron Mountain Club.
Typed initials: *
Your answer
Date: *
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