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Application Form

Summit Hills Country Club

Application Form


Personal Information 
First Name* 
Middle Name
Last Name* 
Street Address* 
City* 
State* 
Zip Code* 
Phone Number
Cell Phone Number
Email Address* 
Are you eligible to work in the United States?*    
 Yes   No
*Proof will be required if employed
If you are under age 18, do you have an employment/age certificate?
 Yes  No
Have you been convicted of a felony?
 Yes  No
If yes, please state Date and Disposition:
General Employment Information
Position Applied For
Referred by:
What date are you available to start work?
Days/Hours Available
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday
Hours Available
From

To
Were you previously employed here?
If yes, when
To
List any relatives presently employed here
List any relatives presently members of Summit Hills Country Club
Education
Name and Address of School - Degree/Diploma - Graduation Date
Skills and Qualifications: Licenses, Skills, Training, Awards
Employment History
Present Or Last Position
Employer
Phone
Email
Address
Supervisor
Position Title
Salary
Start Date
End Date
Salary
Responsibilities
Previous Position
Employer
Phone
Email
Address
Supervisor
Position Title
Salary
Start Date
End Date
Salary
Responsibilities
May we contact your present employers
 Yes  No
References
Name/Title Address
I certify that information contained in this application is true and complete. I understand that false information may be
grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize
the verification of any or all information listed above.

In consideration of my employment, I agree to conform to the rules and regulations for employees. I understand that my
employment and compensation can be terminated, with or without cause, at anytime, at the option of either Summit Hills
Country Club or me. I understand that no representative of Summit Hills Country Club has any authority to enter into any
verbal agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.
Signature* 
Date*