Empire: Junior Staff - Internship Application
519 1/2 W. Commerce
Bryant, AR  72022
501-847-0809
empirecheerleading@gmail.com
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Email *
First Name: *
Last Name: *
Home Address: *
City/State/Zip: *
Cell/Contact Number: *
Personal Email Address: *
Position Applying For: *
Why do you want to be an intern at Empire? *
If you are applying for an internship for a high school course, please fill out the following questions.
High School:
Teacher:
Teacher E-mail:
Teacher Phone: (optional)
Grade Level:
Clear selection
How did you hear about Empire? *
What will be your primary form of transportation to and from work? *
Are you willing to work nights and weekends? *
What days and times are you available to work? *
Have you ever been convicted of a felony or misdemeanor? *
If yes, please explain. *
Applicant Skills:
Please check all that apply.  
List any other skills that may be useful for the job you are seeking.
Office Interns:
Tumbling/Cheerleading Coaching Interns:
Parkour Interns:
Employment History
List your most recent employment.
Employer's Name:
Supervisor's Name:
Job Duties:
Reason For Leaving:
High School: *
College: *
Please indicate any current professional licenses or certifications that you hold: *
Please fill out the following boxes of two personal references.
Non-Relatives
Full Name: *
Phone: *
E-mail: *
Relationship: *
Full Name: *
Phone: *
E-mail: *
Relationship: *
Certification
I certify that the information provided on this application is truthful and accurate.  I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize Empire Cheerleading to contact former employers and educational organizations regarding my employment and education.  I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades.  I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its owner, Brooke Plack, the employment relationship will be "at-will".  In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause.  With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice.  Similarly, my employer will have the right.  Moreover, no agent, representative, or employee of Empire Cheerleading, except in a specific written contract of employement signed on behalf of the organization by its owner, Brooke Plack, has the power to alter or vary the voluntary nature of the employment relationship.

I HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND I UNDERSTAND AND AGREE TO ITS TERMS.
Applicant Signature: *
Date: *
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