EMPLOYMENT APPLICATION

Application for Employment

Lake Naomi Club is an equal opportunity employer and does not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services and programs is available to all persons. Those applicants requiring reasonable accomodation to the application and/or interview process should notify a representative of the organization.

Name: *

First Name Last Name

Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Cell Phone Number: *

Area Code Phone Number

E-mail Address:

Type of Employment Desired: *

Other:

Date you will be available to start:

Date

Date you will be available to work until: (Seasonal Employees Only)

Date

Hours you are available:

Have you ever been employed by the Lake Naomi Club? *

Yes No

If Yes, please specify when and position held:

How were you referred to us? *

Walk-In Employee Newspaper Ad Facebook Other (please specify)

Are you able to meet the attendance requirements? *

Yes No

Do you have any objection to working overtime if necessary? *

Yes No

Can you submit proof of legal employment authorization and identity? *

Yes No

If you are under 18, can you furnish a work permit if it is required? *

Yes No

Have you ever been convicted of a crime? *

Yes No

If Yes, Please Explain: (a conviction will not automatically bar employment)

Upload Resume:

Employment History

Please provide info pertinent to your past 4 employers beginning with the most recent.

Name, Address & Phone Number of Employer #1:

Position with Employer #1:

Salary with Employer #1:

Reason for Leaving Employer #1:

Name, Address & Phone Number of Employer #2:

Position with Employer #2:

Salary with Employer #2:

Reason for Leaving Employer #2:

Name, Address & Phone Number of Employer #3:

Position with Employer #3:

Salary with Employer #3:

Reason for Leaving Employer #3:

Name, Address & Phone Number of Employer #4:

Position with Employer #4:

Salary with Employer #4:

Reason for Leaving Employer #4:

Educational History

List school name and location, years completed, course of study and any defrees earned.

High School:

Years Completed:

Course of Study:

Degrees Earned:

College:

Years Completed:

Degrees Earned:

Graduate School/Other training workshops, certifications, etc:

Additional Questions

The following questions need only be answered by those applying for positions in teh Aquatics, Recreation and Sailing Divisions.

Do you presently hold a Water Safety Instructor's Certificate?

Yes No

If Yes, What is the Expiration Date?

Date

Do you presently hold a Lifeguard Training Certificate?

Yes No

If Yes, What is the Expiration Date?

Date

Do you presently hold a First Aid Certificate?

Yes No

If Yes, What is the Expiration Date?

Date

Do you presently hold a U.S. Sailing Instructor's Certificate?

Yes No

If Yes, What is the Expiration Date?

Date

What sports, hobbies or skills could you teach to a group?

What is your favorite age group to work with?

References

Please give the names of three persons not related to you who you have known at least one year.

Reference 1

Name:

First Name Last Name

Phone Number

Area Code Phone Number

Years Acquainted:

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Reference 2

Name:

First Name Last Name

Phone Number

Area Code Phone Number

Years Acquainted:

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Reference 3

Name:

First Name Last Name

Phone Number

Area Code Phone Number

Years Acquainted:

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

The following questions should be answered by all applicants:

Why do you want to work on the staff team of the Lake Naomi Club?
What benefit do you feel a position with the Lake Naomi Club would be to you?
Describe any relevant extracurricular activities that you have been or are you involved with?

I hereby authorize the potential employer, to contact, obtain and verify the accuracy of information contained in this application from all previous employers, educational institutions and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accomodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to sumbit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand foregoing, and that I seek employment under these conditions.

Applicant Signature:

Clear

Date:

Date