Application for Employment

Application name: *
Address: *
Supplemental Address:
Telephone #:
Cell Phone #:
Email Address:
Type of employment desired:
Desired Position(s) *
Date you will be available to start:
Hours you are available:
Have you ever been employed by Lake Naomi Club?
If yes, when?
If yes, position(s)?
How were you referred to us?
If selected other please define:
Are you able to meet the attendance requirements?
Do you have any objection to working overtime if necessary?
Can you submit proof of legal employment authorization and identity?
IF you are under 18, can you furnish a work permit if it is required?
Have you ever been convicted of a crime?
If yes, please explain:
Employer Name:
Employer Address:
Employer Phone Number:
Position:
Salary:
Start date of employment:
End date of employment:
Reason for leaving:
Employer Name:
Employer Address:
Employer Phone Number:
Position:
Salary:
Start date of employment:
End date of employment:
Reason for leaving:
Employer Name:
Employer Address:
Employer Phone Number:
Position:
Salary:
Start date of employment:
End date of employment:
Reason for leaving:
Employer Name:
Employer Address:
Employer Phone Number:
Position:
Salary:
Start date of employment:
End date of employment:
Reason for leaving:
High School Name:
Years completed:
Course of study:
Degrees Earned:
College Name:
College Years completed:
College Course of study:
College Degrees earned:
Graduate School Name:
Graduate School Years completed:
Graduate School Course of study:
Graduate School Degrees earned:
Other Training or Workshop Name of school:
Other Training or Workshop Years completed:
Other Training or Workshop Course of study:
Other Training or Workshop Degrees earned:
Do you presently hold a Water Safety Instructor?s Certificate?
If yes, Expiration Date:
Do you presently hold a Lifeguard Training Certificate?
Do you presently hold a First Aid Certificate?
If yes, Classification:
Do you presently hold a U.S. Sailing Instructor?s Certificate?
What Sports, Hobbies or Skills could you teach to a group?
What is your favorite age group to work with?
Reference #1 Name
Reference #1 Address
Reference #1 Phone Number
Reference #1 Years Acquainted:
Reference #2 Name:
Reference #2 Address:
Reference #2 Phone Number:
Reference #2 Years Acquainted:
Reference #3 Name
Reference #3 Address
Reference #3 Phone Number:
Reference #3 Years Acquainted:
Brief Statement: