Lake Summerset Application

LAKE SUMMERSET ASSOCIATION, INC.

APPLICATION FOR EMPLOYMENT

1202 Lake Summerset Rd Davis, IL 61019

An Equal Opportunity Employer
Last Name
First Name
Address

Current Address

Street Address Line 2

CityState

Zip Code
Cell Phone
Please enter a valid phone number.
Please check position you are applying for:

Office - Part-timeMaintenanceSafety - GuardhouseSafety - Land PatrolSafety - Seasonal
Have you ever been employed by Lake Summerset Assoc., Inc. before?

YesNo
Indicate department and dates

MonthDayYear
Date
Date available for employment

MonthDayYear
Date
Are you available ?

Saturdays for OfficeWeekends for Guardhouse/Land PatrolNights for Guardhouse/Land Patrol3rd Shift Guardhouse (11pm-7am)
Any restrictions on hours weekends or overtime If yes explain
Are you over 18 years of age?

yesnoover 24 years
High School Graduation date

Type a question

	Name	Employment Dates	Position	Wages
Employer
Employer
Employer

Personal Driving Record This section is to be completed ONLY if the operation of a motor vehicle will be required in the course of the applicant's Employment Driver's license number Expiration date Do you have a current Issuing state
Do you have a current CDL?

yesno
Drivers license number
Expiration date

MonthDayYear
Date
Issuing state
List any other states in which you have had a drivers licenses in the past
Within the past five years have you had a vehicle accident
Is your driver's license restricted?

yesno
If yes explain
Has your driver's license ever been revoked or suspended?

yesno
If yes explain
Applicant's Statement:

I certify that the information given on this application is true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application, and understand that false or misleading information given in my application or interview(s) may result in discharge.

I understand and agree that, if hired, my employment will be for no definite period and may, regardless of the date of payment of wages, be terminated at any time without previous notice and with or without reason, at the will of either myself or Lake Summerset Association. I also understand and agree that no one has authority to promise me job security or continued employment, except the Manager of Lake Summerset Association in a formal written agreement signed by both of us.
Signature of Applicant

Clear
Date

MonthDayYear
Date
We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, martial or veteran status, the presence of a non-job-related medical condition or handicap, or any other legally protected status.

Proof of citizenship or immigration status will be required upon employment.
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