Employment Application Form Personal Information First Name Last Name Phone Number Referred By Present Address City State Zip Code Previous Address (If at a present address less than 2 years ago) City State Zip Code Employment Desired Position Desired Date You Can Start Salary Desired Have You Ever Worked at a Country Club Before? YesNo If So, When and Where? Ever Applied to This Club Before? YesNo If So, When? Education Name & Location of School Years Attended Did You Graduate? Subjects Studied Grammar School YesNo High School YesNo College YesNo Trade, Business, or Correspondence School YesNo General Information Special Training / Skills U.S. Military or Naval Service Rank Former Employers (Start with last one first) Name & Address of Employer Dates of Employment Salary Position Reason for Leaving May We Contact Your Present Employer?YesNo References Name Business Phone Years Known “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 the statements on this application shall be grounds for dismissal. I authorize investigation of all 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 and otherwise, and release Benvenue Country Club from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of Benvenue Country Club 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 Benvenue Country Club representative. Thais waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the American with Disabilities Act (ADA) and other relevant federal and state laws.” Signature Date Saving Information...Please Wait