Employment

First Name

Last Name

Present Address

Permanent Address

Phone #

Position

Date You Can Start

Salary Desired

Are you employed now?

Yes No

If so, may we contact your present employer?

Yes No

Have you applied to this company before?

Yes No

If so, when?

High School Name, Years Attended, Subjects Studied

College Name, Years Attended, Subjects Studied

Trade School Name, Years Attended, Subjects Studied

Subject of Special Study

Special Training, Certifications, Licenses

Special Skills, Foreign Languages, etc.

Please include the name and address of the employer, dates worked, salary, position, and reason for leaving for each instance of employment.

Please include the name, address, business, phone, and years known for each reference.

Have you every been convicted of, plead guilty/no contest to, or had a suspended imposition of sentence for any offense (other than a minor traffic violation)?

Yes No

If yes, explain. Please note you will not be denied employment solely because of a conviction record, unless the offense is related to the job for which you have applied.

Type your name below.

Emergency Contact Name and Phone #

By submitting this form, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

We would love for you to join the friendly team here at Radley Run! At our club, we are devoted to our three core values: Commitment, integrity and collaboration. These three values are always displayed towards our members and each other. Our culture reflects our desire to evolve and grow through community, friendship, and sport and we would love to have you on board for our continued expansion!