Pre-Employment Application

Name

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How were you referred to Birmingham Country Club?

Position Applying For:*

Are You applying for

Are you applying for*

What days and hours are you available to work?*

If hired, what date can you start working?

Can you work weekends?*

Yes
No

Can you work evenings?*

Yes
No

Are you available to work overtime?*

Yes
No

Have you ever applied to or worked for Birmingham Country Club before? If yes, please explain (include dates)*

Do you have any friends, relatives or acquaintances working for Birmingham Country Club?*

Yes
No

If yes, please list names*

Are you over the age of 18?*

Yes
No

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?*

Yes
No

If hired, are you wiling to submit to and pass a controlled substance test?

Yes
No

Have you ever been convicted of a criminal offense (felony or misdemeanor)*

Yes
No

Are you currently employed?*

Yes
No

If you are currently employed, may we contact your current employer?*

Yes
No

Below please describe past and present employment positions dating back 5 years.

Name of Employer*

Name of Supervisor*

Phone*

Business Type*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Length of Employment*

Position and Duties*

Reason for Leaving*

May we contact this employer for references?*

Yes
No

Name of Employer #2

Name of Supervisor

Phone

Business Type

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Length of Employment

Position and Duties

Reason for Leaving

May we contact this employer for references?

Yes
No

Name of Employer #3

Name of Supervisor

Phone

Business Type

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Length of Employment

Position and Duties

Reason for Leaving

May we contact this employer for references?

Yes
No

By clicking the submit button you certify that you have not purposely withheld any information that might adversely affect your chances for hiring. You attest to the fact that the answers given are true and correct to the best of your knowledge. You understand that any omission (including any misstatement) of material fact on this application or on any document used to secure employment can be grounds for rejection of application or, if you are employed by Birmingham Country Club, terms for your immediate expulsion from the company.

Pre Employment Application