Texarkana/Northridge Country Club
Employment Application
Personal Information
Name
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your social security number?
*
Position Applied for:
What is your available start date?
-
Month
-
Day
Year
Date
Are you able to lift at least 25 lbs?
*
Yes
No
Are any duties you are unable to perform?
*
Yes
No
If yes, explain
Are there accommodations we can make?
*
Yes
No
If yes, explain
Are you a citizen of the United States?
*
Yes
No
If no, are you authorized to work in the U.S.?
Yes
No
Have you ever worked for this company?
*
Yes
No
If yes, when?
Have you ever been convicted of a felony?
*
Yes
No
Have you ever been convicted for any crime, including sex-related or child-abuse-related offenses?
*
Yes
No
If yes, explain?
Education
High School and year you graduate/graduated?
College attending and year you graduate/graduated?
Other education:
Work Experience
Qualifications
If you have resume please upload here (Not required)
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of
Military Service
Branch
From:
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Month
-
Day
Year
Date
To:
-
Month
-
Day
Year
Date
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:
Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
Submit
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