BHCC Application Form

Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Position Applied For
Date Available

MonthDayYear
Date
How many hours per week are you looking for?
How many months of employment are looking for?
Desired Salary
Are you a citizen of the United States?

YesNo
If no, are you authorized to work in the U.S.?

YesNo
Have you worked for us previously?

YesNo
If yes, when/where?
List any friends or relatives working for us
Do you have any impairment (physical, mental, medical) which would interfere with your ability to do the job(s) for which you are applying?

YesOther
Have you been convicted of a crime?

YesNo
If Yes, Please Explain
Do you have any charges pending against you?

YesNo
If Yes, Please Explain
High School
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Did You Graduate?

YesNo
College
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Did You Graduate?

YesNo
Other
Address
From

MonthDayYear
Date
To

MonthDayYear
Date
Did You Graduate?

YesNo
If you were in school within the past two years, how many days were you absent or late?
Do you have any skills, qualifications or experiences which you feel would especially fit you for work with the Club?
If hired, do you have reliable means of transportation to get to work?

YesNo
Are you 18 years or older?

YesNo
Armed forces service?

YesNo
From

MonthDayYear
Date
To

MonthDayYear
Date
Branch of Service
Duties
Rank of Time of enlistment
Rank of Time of discharge
Previous Employment
Company Name
Phone Number
Please enter a valid phone number.
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From

MonthDayYear
Date
To

MonthDayYear
Date
Reason for Leaving
May we contact your previous supervisor for a reference?

YesNo
Previous Employment
Company Name
Phone Number
Please enter a valid phone number.
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From

MonthDayYear
Date
To

MonthDayYear
Date
Reason for Leaving
May we contact your previous supervisor for a reference?

YesNo
References-Please List Three

First NameLast Name
Company
Phone
Relationship
Name

First NameLast Name
Company
Phone
Relationship
Name

First NameLast Name
Company
Phone
Relationship
Any additional information
Notice to all participants:

Before any applicant can begin work, the person must be able to verify, under federal law, that he or she is authorized to work in the United States. All applicants offered a position with Barton Hills Country Club will have to document their authorization to work before the hiring process will be complete.

All applicants are being notified at this time that, if selected for hire, it will be your responsibility to provide Barton Hills Country Club with documentation showing your right to work. Barton Hills Country Club is giving you this notice so you may have those documents ready if you should be offered a position with the Club. The documents will be reviewed by the Personnel Department at the time a
conditional offer of employment is made.

What is your availability? List the hours you WILL be available to work; if a student, when is your expected last day of work prior to the next school year?

	Mon	Tues	Wed	Thur	Fri	Sat	Sun
Jan thru April
May thru August
Sep thru December

BARTON HILLS COUNTRY CLUB BACKGROUND CHECK POLICY
All applicants that are 18 years old or over and have been offered a position at the BHCC pool/tennis facility, or anyone that will have direct involvement with the Barton Hills children (examples, but not inclusive, are Date Night or Junior Golf sitters) will be required to have a background check.
I, blanks am aware of and agree to the above background check. I understand that the position I have been offered is contingent on the above background check results.
Date

MonthDayYear
Date
Print Name
Signature
APPLICANTS CERTIFICATION AND AGREEMENT

Please read carefully:

1. Certificate of Truthfulness.
I certify that all statements on this application for employment are made truthfully and without evasion, and further understand and agree that such statements may be investigated and if found to be false will be sufficient reason for not
being employed, or if employed may result in dismissal.

2. Authorization for Employment Information.
I authorize the references I have listed above, and any prior or current employer of mine, to give you any and all information and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing such information to you. Also, I hereby waive written notice to me that employment information is being provided by any person or organization.

3. Employment At Will
If hired, in consideration of my employment I agree to abide by the rules and policies of Barton Hills Country Club. I further agree that such employment and all compensation can be terminated with or without cause, and with or
without notice, at any time at the option of either Barton Hills Country Club or me. I understand that no agent or representative of Barton Hills Country Club, other than its President, has any authority to enter into any agreement for
employment contrary to the foregoing and that the President’s authority to do so may be exercised only by a written employment agreement signed by Barton Hills Country Club’s President.
Signature
Date

MonthDayYear
Date
Should be Empty: