Southland Pool Application
Qualified applicants are considered without regard to race, color, lifestyle, religion, sex, national origin, age, or marital status.
Application Date *
MM
/
DD
/
YYYY
Full Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Position Desired *
Check all that apply.
Required
Are you looking for full or part time work? *
What is your availability? *
Check all times that you HAVE availability.
AM
PM
Both
Neither
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How many days off do you anticipate taking this summer? *
This includes days needed for school events, vacation, or any family gatherings.
Do you have a valid driver's license? *
Education *
Check all that apply.
Required
Please list any honors or awards you have received.
Your answer
Please list any special skills or qualifications you possess?
Your answer
Would this be your first job? *
Previous work experience #1
Please include dates, reason for leaving, a contact person/number, and if you are eligible for rehire.
Your answer
Previous work experience #2
Please include dates, reason for leaving, a contact person/number, and if you are eligible for rehire.
Your answer
Previous work experience #3
Please include dates, reason for leaving, a contact person/number, and if you are eligible for rehire.
Your answer
References *
Please list two references, their relationship to you, and a contact phone number. Please do not include family members.
Your answer
Have you ever been convicted of a misdemeanor or felony other than a minor traffic violation? *
If yes please explain.
Your answer
I hereby swear or affirm that the statements herein are true and correct. I authorize Southland Family Club to investigate all statements made by me, authorize all references and former employers to freely furnish all information requested to Southland and release Southland from liability for damages resulting from furnishing or obtaining such information. By typing my name and date below, I authorize a background check and understand that my potential employment will be based on information obtained.
Type name and date *
Your answer
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