PAC Employment Application | Prairie Athletic Club

First Name *

Last Name *

Email Address *

Phone Number *

Street Address *

Apartment, suite, etc

City *

State *

ZIP Code *

Department / Position/s Desired *

When Are You Looking To Start *

What Type of Employment? *

Are you legally eligible to work in the United States? *

How did you hear about this position?

How many hours would you like to work? *

Wage / Salary Requirement *

Have You Ever Worked At PAC *

Position Held:

Date Held:

Monday Hours

Tuesday Hours

Wednesday Hours

Thursday Hours

Friday Hours

Saturday Hours

Sunday Hours

Elementary School Name & Location

High School Name & Location

College Name & Location

Graduate Name & Location

Vocational Name & Location

List / Describe any certifications or training0 / 500

Please list any academic honors, scholarships etc0 / 500

Please describe why you're applying to PAC0 / 500

Employment History

please list your two most recent employers, you'll have the opportunity to submit your resume after you submit the application

Company Name

Job Title

Supervisor Name

Employment Dates

Street Address

City

State

Company Phone

Can we contact your previous employer?

Job Duties and/or reason for leaving0 / 500

continued...

Company Name

Job Title

Supervisor Name

Employment Dates

Street Address

City

State

Company Phone

Can we contact your previous employer?

Job Duties and/or reason for leaving0 / 500

Applicant's Statement

I certify that all information provided on this application and all other documents I have provided to secure employment with Prairie Athletic Club is true and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any way will be sufficient cause to cancel further consideration of this application, or immediately discharge me from the service of Prairie Athletic Club, whenever it is discovered.

I understand that submission of this application does not guarantee employment. I further understand that should an offer of employment be extended by Prairie Athletic Club, my employment will be at will, meaning that I am free to resign at any time with or without cause and without prior notice. I understand that Prairie Athletic Club reserves the same right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of Prairie Athletic Club has the authority to make any assurances to the contrary and that no implied, oral or written agreements to the contrary are valid unless they are in writing and signed by the Owner or Human Resources representative.

I authorize Prairie Athletic Club, its agents, employees or representatives to contact my former employers, references, courts, schools and any other individual who may have information pertaining to my previous employment, education, skills, work habits or experience in order to verify the accuracy of information provided by me in this application, resume or job interview, and to provide any other requested information about me. I release all parties involved from any and all liability for providing or requesting such information.

I understand that this application will remain active for 90 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to re-apply and submit a new application.

By signing (entering my name & checking the box) below I acknowledge that I have read, understood and agree to the above statements.

I understand and agree to the above statement.YesNocheck box

Name

Date

APPLICATION