Five Star Life Application 2026

Five Star Life Application 2026
Select Type of Application (must choose 1)
Basic Information
Full Name

First NameMiddle NameLast Name
Today's Date

MonthDayYear
Date
Have you been involved with Five Star Life previously?
If you selected yes, please explain:
How did you hear about Five Star Life?
Birth Date

MonthDayYear
Calculation
Gender
Phone Number
Format: (000) 000-0000.
E-mail
Address

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Format: (000) 000-0000.
Parent/Guardian E-mail
Emergency Contact Information
Emergency Contact #1
Emergency Contact #1 Relationship to You
Emergency Contact #1 Phone Number
Format: (000) 000-0000.
Emergency Contact #2
Emergency Contact #2 Relationship to You
Emergency Contact #2 Phone Number
Format: (000) 000-0000.
Education
What is your highest level of education?
What year did you graduate or do you plan to graduate?
What did you study?
What school did you attend for your highest education?
City and State for Highest Education
Previous Employment
Name of Most Recent Employer
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Format: (000) 000-0000.
Starting Date

MonthDayYear
Ending Date

MonthDayYear
Salary
Do you have another employer to list?
Name of Employer #2
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Format: (000) 000-0000.
Starting Date

MonthDayYear
Ending Date

MonthDayYear
Salary
Do you have another employer to list?
Name of Employer #3
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Format: (000) 000-0000.
Starting Date

MonthDayYear
Ending Date

MonthDayYear
Salary
Coaching Stops
Most Recent Coaching Position
Head Coach's Name
School Name
Phone Number
Applicant's Coaching Role
What were your responsibilities?
Tenure
How long were you there?
Coaching Position #2
Head Coach's Name
School Name
Phone Number
Applicant's Coaching Role
What were your responsibilities?
Tenure
How long were you there?
Coaching Position #3
Head Coach's Name
School Name
Phone Number
Applicant's Coaching Role
What were your responsibilities?
Tenure
How long were you there?
References

REFERENCES CANNOT BE A RELATIVE OR FIVE STAR LIFE STAFF MEMBER
List at three adults you have known for at least one year, who are not related to you or Five Star Life employees and have a definite knowledge of your character and ability to work with students.
Reference #1 Name

First NameLast Name
Reference #1 Phone Number
Format: (000) 000-0000.
Reference #1 E-mail
example@example.com
Relationship
Reference #2 Name

First NameLast Name
Reference #2 Phone Number
Format: (000) 000-0000.
Reference #2 E-mail
example@example.com
Relationship
Reference #3 Name

First NameLast Name
Reference #3 Phone Number
Format: (000) 000-0000.
Reference #3 E-mail
example@example.com
Relationship
General Application Questions
What position are you applying for?
What size T-shirt do you wear?
Please list any experience you have working with kids
Why do you want to get involved with Five Star Life?
List any Five Star Life Staff or Volunteers you know?
Please state why you are qualified for this position.
What skills do you have that will benefit you in this position?
If hired, can you provide proof you are eligible to work in the U.S.?
Do you have an active checking account (for payroll deposits)?
Integrity - who you are when no one is looking...the real you
Respect - treat others the way you want to be treated
Responsibility - taking ownership of your past choices, current reality and future dreams
Courage - the strength to do what is right over what is popular
Sacrifice - giving up something now for something greater later or giving up something you want in order to help someone else win
Initiative - the power or opportunity to act or take charge before others do
Commitment - devoted to a task or purpose
Communication - interchange of thoughts, opinions, or information by speech, writing, or signs
Coachable - willing to be pushed to be improved
Team Participation - thrives in various and diverse environments
List all previous work involving children (organization name, city, state, type of work)
Upload Resume *Job Application

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Headshot

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Personal History
Five Star Life/Summit

Disclosure Form - Five Star Life and Summit cares about the children and youth in our programs and desires to ensure their safety while they are in our supervision. Because we care for children and youth, our organizations join in asking any new staff member or volunteer who will be interacting with children and/or youth, to complete this disclosure form. Please complete the following questions by circling the appropriate response. Please attach an explanation for any "yes" answer.
1. Have you ever been arrested, accused, pleaded guilty or no contest, and/or convicted of criminal offense, abuse, or sexual misconduct of any kind?
2. Have you been released from incarceration for a conviction of criminal behavior of any kind within the past five years?
3. Within the past 6 months, have you used illegal drugs?
4. Has your driver’s license been suspended or revoked within the last seven years?
5. Is there any fact, circumstance, or pattern involving your background, or any trait or tendency you possess that could pose a threat to children, youth, or vulnerable adults, or that could make it inappropriate for you to serve with minors or would compromise the integrity of the Five Star?
6. Will you require any accommodations in order to perform the specific duties of this role?
If you answered yes to any of the personal history questions above, please explain here.
Liability Release
Signature
Parent/Guardian Signature
Thank you for applying with Five Star Life. Please complete our background check. You will be directed to this page after you submit your application.

** If you have already submitted a background check with Five Star Life, there is no need to fill out the next page. Thank you.
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Basic Information

Emergency Contact Information

Education

Previous Employment

Coaching Stops

References

General Application Questions

Personal History

Liability Release