Employment Application — Timber Creek Golf Course

Name

First Name

Last Name

Phone

(###)

###

####

Email Address

Present Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you over 18?

Yes

Driver's License State

Drivers License Type:

Is your Drivers License currently valid?

Yes

EMPLOYMENT DESIRED

Position Applied for:

Hourly Rate Desired?

Date Available to Start?

YYYY

Are there any days or hours you would be unable or unwilling to work?

Work History

List names of employers, in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give full name and supply business references.

Name of Employer 1

Dates Worked at Employer 1

When did you work (month/year to month/year)?

Employer 1 Name and Title of Last Supervisor? *

Employer 1 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Pay at Employer 1?

Employer 1 Phone

(###)

###

####

Reason for Leaving Last Job?

Title at Employer 1 Job?

Duties at Employer 1?

Name of Employer 2

Dates you worked at Employer 2

When did you work at Employer 2? (month/year to month/year)

Employer 2 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Pay at Employer 2?

Employer 2 Phone

(###)

###

####

Employer 2 Reason for Leaving?

Title at Employer 2?

Duties at Employer 2

REFERENCES

Give three references, not relatives or former employers.

Reference 1 Name

Reference Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference 1 Phone

(###)

###

####

Reference 1 Occupation

Reference 2 Name

Reference 2 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference 2 Phone

(###)

###

####

Reference 2 Occupation

Reference 3 Name

Reference 3 Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference 3 Phone

(###)

###

####

Reference 3 Occupation

Employment Application Addendum

Equal Opportunity Employer Questionnaire For Federal/State Statistical Reporting Requirements All applicants for employment are requested to complete this form. Your voluntary submission of this information will assist Timber Creek Golf Course to comply with Federal Equal Opportunity statistical reporting and research requirements. Data collected will be used for statistical reporting purposes and to measure the effectiveness of recruitment efforts and selection process. Your refusal to complete this form will not affect the status of your application. This section will be detached from the application and will not become a part of your file. It will be kept confidential and retained separately for statistical purposes ONLY. Timber Creek Golf Course is an equal opportunity employer. In accordance with applicable laws and regulations, Timber Creek Golf Course does not discriminate on the basis of disability or other prohibited criteria. Any applicant who feels discriminated against in his or her opportunity for employment because of race, color, creed, national origin, age, political affiliation, disability or any other non-merit factor has the right to file a complaint.

Age

Under 20

20-39

40-65

66 or older

Are you a veteran of the United States Armed Forces

Yes

If a veteran, which Branch of Service?

Type of Discharge?

Have you been unemployed in the past 60 days?

Yes

DISCLOSURE - PREPARATION OF A CONSUMER REPORT

To process your application with Envision Catering & Hospitality an investigative consumer report (background check) may be conducted by Verified Credentials, Inc. In accordance with the U.S. Fair Credit Reporting Act § 606, we notify you of the following: A background check report may contain information bearing on your character, general reputation, personal characteristics, mode of living and credit standing. Information may include, but is not limited to; employment history, education, criminal records, credit history, motor vehicle records, personal references, and any data provided on this application, or during the interview process.

If currently employed, may your current employer be contacted?

Yes

AUTHORIZATION - TO PREPARE INVESTIGATIVE CONSUMER REPORT

Please read the following and, if acceptable, authorize us to order an investigative consumer report to be prepared by Verified Credentials, Inc. I authorize the appropriate individuals, companies, institutions or agencies to release information requested for the preparation of an investigative consumer report on me and to respond to all inquiries necessary for the same. I further understand and waive my right of privacy in this investigation and release and hold harmless Envision Catering & Hospitality and its agents Verified Credentials, Inc., from any liability. An investigative consumer report may be generated summarizing this information. I have a right under the “Fair Credit Reporting Act” to obtain a copy of this report by providing proper identification and directing a written request to Verified Credentials Inc, 20890 Kenbridge Ct., Lakeville, MN 55044. 1-800-473-4934. I may also obtain a copy of this report by checking the “Yes” box below.

I request a copy of the report

Yes

AFFIDAVIT

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application form or during any interviews may be grounds for my immediate discharge. l hereby authorize the company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right; to bring any course of action against these individuals for defamation, invasion of privacy or any other reason because of their statements. I agree that if I am employed, I will abide by all the rules and regulations of the company. I understand that the taking of drug and alcohol tests, when given pursuant to company policy, are condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination. I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of the President of the Company. I also understand that my employment is ‘at will’ and may be terminated by myself or by the company at any time for any reason or no reason at all, with or without prior notice.

Digital Signature

Please type your first and last name here to digitally sign this Employment Application

Today's Date

YYYY