Huron Mountain Club Keeper Application
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.

Please be aware that COVID conditions call for new demands in mutual trust. The Huron Mountain Club required a COVID vaccination for employees, and your employer family may require one as well. Your employer family may have lifestyle restrictions through the period of your employment in order to maintain the health of their home. Failure to comply with such restrictions will be grounds for termination.
Sign in to Google to save your progress. Learn more
Background information
Name (ex. Last, First): *
Email: *
Phone number (ex. 555-555-5555): *
Dates you are available (ex. July 1 - August 31): *
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 2020)?
Dates and names of families you are already scheduled with (ex. Smith/July 1 - August 1):
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?
Have you ever been convicted of a crime? *
If yes, please explain:
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:
Employer #2, supervisor's name, contact number, length of employment, reason for leaving:
Employer #3, supervisor's name, contact number, length of employment, reason for leaving:
Education History
Please fill in the details of your education history
High school name: *
Did you graduate from high school? *
College name:
Number of years or degree earned:
Field of study
Outdoor Activities Program Information
Why do you want to work as a keeper at the Huron Mountain Club? *
Describe any experience you have in working with children under the age of 12. *
Describe any special skills or talents you can offer the Outdoor Activities Program.
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
Reference #2 name, years acquainted, phone number
Reference #3 name, years acquainted, phone number
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: *
Date: *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms