Employment | Clarksville Athletic Club

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Date of Birth *

Projected Start Date *

Desired Salary/Wage

How did you hear about this opportunity?

Have you ever pled "guilty" or "no contest" to, or been convicted of a crime? *

Yes
No

*Answering “Yes” to these questions does not constitute an automatic bar to employment. Factors such as date of offense, seriousness, and nature of the violation, rehabilitation, and position applies for will be taken into account

Educational Background

High School:

Number of Years attended:

College:

Location:

Number of Years attended:

Degree Earned:

Major/ Area of Concentration:

Skills and Qualifications

Summarize any training, licenses, and/or certificated that may qualify you as being able to perform job-related functions to the position for which you are applying. Explain why you feel you are qualified for this position and would be the best choice:

Work History

Company

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Company Phone

Position Held

Dates of Employment

Starting Pay Earned

Ending Pay Earned

Supervisor Name

May We Contact for Reference?

Yes
No

Company

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Company Phone

Position Held

Dates of Employment

Starting Pay Earned

Ending Pay Earned

Supervisor Name

May We Contact for Reference?

Yes
No

Company

Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Company Phone

Position Held

Dates of Employment

Starting Pay Earned

Ending Pay Earned

Supervisor Name

May We Contact for Reference?

Yes
No

Statement of Applicant *

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct.
I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i)cancel further consideration in this application, or (ii)immediately discharge me from the employer’s service, whenever it is discovered.
I expressly authorize, without reservation, the employer, its representative, employees or agents to contact and obtain information from all references(personal and professional) employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview.
I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state or federal law.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration.
I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement.

Signature *

Today's Date *

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