Premier at Sawmill Athletic Club Employment Application

PERSONAL INFORMATION	Date:
Name: Address: City: State: Zip: Day Phone #: Home Phone #: Email: Are you 18 years old or older? Yes No
EMPLOYMENT DESIRED
Full Time Part Time Hours Available: Department (check all that apply) Lifeguard Group Exercise Instructor Maintenance Swim Instructor Membership Services/Sales Locker Room/Fitness Floor Water Fitness Instructor Service Desk Massage Therapist Bistro Team Member Kids Club Team Member Esthetician Personal Trainer Summer Camp Counselor   Nail Technician Preferred Position: Date you can start: Are you currently employed? Yes  No If Yes, who is your employer? Have you ever applied to or been employed by Premier at Sawmill Athletic Club? Yes  No Have you ever been employed by our club affiliates? Kinsale Golf & Fitness Club   Scioto Reserve Golf & Athletic Club
EDUCATION
Name & Location of School # Yrs. Attended Field of Study Graduated High School Yes No College Yes No Trade/Bus/Corres/Military Yes No
SPECIAL SKILLS OR CERTIFICATIONS
Type Expiration Date Authorizing Organization WSI CPR First Aid Group Ex. Cert. PT Certification
FORMER EMPLOYERS (List below your last three employers, starting with the most recent first.)
Date  (month & year) Employer Name & Address Salary Position Reason for Leaving From: To: From: To: From: To:
REFERENCES (Give the names of three people not related to you, whom you have known for at least one year.)
Name Address Business Phone Years Known
Are your related to a Premier employee Yes  No
PHYSICAL RECORD
Do you have any physical limitations that preclude you from performing any work which you are being considered? Yes  No If Yes, what can be done to accomodate the limitation? In case of emergency, notify: Name: Address: Phone: Relationship:
CRIMINAL RECORD
Have you at any time been convicted, other than in juvenile court, of a felony or misdemeanor other than minor traffic violations? A criminal record does not constitute automatic bar to employment but will be considered in terms of the work to be performed. Failure to discluse a criminal conviction will result in termination. Yes  No      If yes, please give the date(s), city, offense and disposition: Dates(s): City: Offense: Disposition:
“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 information on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and pertinent information they may have personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I give Premier at Sawmill permission to seek a copy of my arrest record from the Franklin County Sheriff’s Office. I do hereby release the Franklin County Sheriff’s Office and all individuals connected therewith from all liability. I understand and agree that, if hired, my employment is for no definite period and may, regardless of date of payment of my wages and salary, be terminated without any prior notice.”
Yes  No
ACKNOWLEDGE YOU HAVE READ THE ABOVE STATEMENTS BY INCLUDING YOUR INITIALS AND TODAY'S DATE: Initials: Date: