Application for Exit 76 Nutrition

Application for Employment Exit 76 Nutrition LLC
FULL NAME
DATE

MonthDayYear
Date
ADDRESS
PHONE
EMAIL
example@example.com
Social Security Number
DOB
Have you worked in a nutrition club before?
If YES, please list the name of the club, city and state, dates you were employed.
In a few word, please describe why you want to be a part of the Exit 76 Nutrition Team?
HOW DID YOU HEAR ABOUT THIS POSITION
DATE AVAILABLE To Start

MonthDayYear
Date
DO YOU HAVE A RELIABLE SOURCE OF TRANSPORTATION?
IF YES, DO YOU HAVE YOUR OWN CAR?
EMPLOYMENT DESIRED: FULL-TIME; PART-TIME; SEASONAL
SUNDAY - PLEASE LIST TIME AVAILABLE FOR THIS DAY
MONDAY - PLEASE LIST TIME AVAILABLE FOR THIS DAY
TUESDAY- PLEASE LIST TIME AVAILABLE FOR THIS DAY
WEDNESDAY - PLEASE LIST TIME AVAILABLE FOR THIS DAY
THURSDAY - PLEASE LIST TIME AVAILABLE FOR THIS DAY
FRIDAY - PLEASE LIST TIME AVAILABLE FOR THIS DAY
SATURDAY - PLEASE LIST TIME AVAILABLE FOR THIS DAY
EMPLOYMENT ELIGIBILITY
ARE YOU A U.S. CITIZEN? YES / NO
*IF NO to the previous question, ARE YOU ALLOWED TO WORK IN THE U.S? YES / NO
HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES / NO
IF YES PLEASE EXPLAIN
BACKGROUND CHECK/DRUG SCREENING
IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK? YES / NO
IF ASKED, ARE YOU WILLING TO CONSENT TO A DRUG SCREENING? YES / NO
EDUCATION
HIGH SCHOOL
CITYSTATE
FROM
TO
GRADUATE? YES / NO
DIPLOMA
GPA
COLLEGE
CITY, STATE
FROM
TO
GRADUATE? YES / NO
DEGREE
GPA
OTHER
CITY, STATE
FROM
TO
DEGREE
ADDITIONAL EDUCATIONAL INFORMATION awards clubs athletics etc
EMPLOYMENT HISTORY
EMPLOYER 1
EMPLOYER 1 EMAIL
example@example.com
EMPLOYER 1 PHONE
EMPLOYER 1 ADDRESS
CITY
STATE
ZIP CODE
STARTING PAY
ENDING PAY
RESPONSIBILITIES
STARTING DATE

MonthDayYear
Date
ENDING DATE

MonthDayYear
Date
EMPLOYMENT HISTORY CONT'D
EMPLOYER 2
EMPLOYER 2 EMAIL
example@example.com
EMPLOYER 2 PHONE
EMPLOYER 2 ADDRESS
CITY
STATE
ZIP CODE
STARTING PAY
ENDING PAY
RESPONSIBILITIES
STARTING DATE

MonthDayYear
Date
ENDING DATE

MonthDayYear
Date
REFERENCES
REFERENCE 1
RELATIONSHIP
COMPANY
TITLE
EMAIL
example@example.com
PHONE
REFERENCE 2
RELATIONSHIP
COMPANY
TITLE
EMAIL
example@example.com
PHONE
DISCLAIMER
Applicant understands that Exit 76 Nutrition, LLC is a private employer and the owner and management have full authority on deciding who is "hired." Applicant understands that the owner is committed in considering all applicants, despite their age, race, ethnicity, sex, disability, etc but is not required to higher anyone whom doesn't meet the qualifications need to perform the task for the job. The relationship between you and Exit 76 Nutrition, LLC is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or Exit 76 Nutrition, LLC. No representative of Exit 76 Nutrition, LLC has the authority to enter into any agreement contrary of the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and the owner of Exit 76 Nutrition, LLC. In the event you that you would like to withdraw your employment , we do ask that you provide us the courtsey of a 2 week minimum notice.

In order to ensure this application is acceptable, please fill out the application in its entirety and to the best of your ability. I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated.
SIGNATURE

Clear
DATE

MonthDayYear
Date
PRINT NAME
Should be Empty:

EMPLOYMENT ELIGIBILITY

BACKGROUND CHECK/DRUG SCREENING

EDUCATION

EMPLOYMENT HISTORY

EMPLOYMENT HISTORY CONT'D

REFERENCES

DISCLAIMER