Application for Employment

Application for Employment
Desired Start Date*

MonthDayYear
Date
Position Department / Role*
Name First / Last*
Address*
Cell Phone Number*
Home Phone Number
Are you at least 21 years old?
Are you legally permitted to work in the U.S.?
High School Education
Years (completed or in progress)
College or Technical Education
Years (completed or in progress)Years
In the past 10 years, have you ever been convicted of a crime other than a minor traffic offence? If yes, please explain:
A conviction will not necessarily automatically disqualify you from employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered.

Experience: (enter present/ last job first)

In case of an emergency, contact: Name*
Emergency Contact Address*
Emergency Contact Phone Number*
Salary Desired Per/ Hour*
What days or nights can you work?*
I hereby certify that the facts set forth above are true and complete to the best of my knowledge and authorize James River Country Club to verify their accuracy and obtain reference information on my work performance. I understand that falsified statements of any kind or omissions of facts may result in disqualification for consideration for employment, or if already implied, may result in immediate termination.
Date*

MonthDayYear
Date
Signature*

Clear
Email*
example@example.com
Should be Empty: