APPLICATION

      FOR EMPLOYMENT

Sports Academy & Racquet Club  1655 E. North  North Logan, UT 84341   (801)753-7500

(Please print clearly)  Date______________________________________________
Name_______________________________ Social Security No.__________________________________

Present Address_________________________________________________Phone___________________
Are you eligible for employment in the U.S.A.? Yes______No______(if yes, verification will be required)

Are you at least 18 years old?           Yes______ No_____
Driver’s License Number____________________________________ Expiration Date________________

Position(s) applied for__________________________________________________________
Have you filed an application here before? Yes ____ No____ If yes, give date _______________________

Were you previously employed by us? ______ If yes, when? _____________________________________
On what date would you be available for work? _______________________________________________

Are you available to work Full Time ____ Part Time ____ Are you willing to relocate? Yes_____ No_____
Are any of your education or employment records under another name? ____________________________
If so, please list: _______________________________________________________

Are there any other experiences, skills, or qualifications which will be of special benefit in the job for where you are applying? Applicant should not list any information that Federal and State Law
Precludes obtaining this time. ______________________________________________________________     _________________________________________________________________
Other industry training? __________________________________________________________________
______________________________________________________________________________________
EMPLOYMENT HISTORY
List below present and past employment, beginning with your most recent.

Name and address of
From
 To
Beginning
Ending
Reason for Leaving
 Name of
Full time
 Part time
company and
Mo./Yr.
 Mo./Yr.
 rate of pay
 rate of pay
  
 supervisor
    
type of business
  
  
  
  
  
  
  
  
 
 Describe the work you did in complete sentences:
 
  
  
 
  
              
 
  
              
Phone
  
  
  
  
  
  
  
  

Name and address of
From
 To
Beginning
Ending
Reason for Leaving
 Name of
Full time
 Part time
company and
Mo./Yr.
 Mo./Yr.
 rate of pay
 rate of pay
  
 supervisor
    
type of business
  
  
  
  
  
  
  
  
 
 Describe the work you did in complete sentences:
 
  
  
 
  
              
 
  
              
Phone
  
  
  
  
  
  
  
  

Name and address of
From
 To
Beginning
Ending
Reason for Leaving
 Name of
Full time
 Part time
company and
Mo./Yr.
 Mo./Yr.
 rate of pay
 rate of pay
  
 supervisor
    
type of business
  
  
  
  
  
  
  
  
 
 Describe the work you did in complete sentences:
 
  
  
 
  
              
 
  
              
Phone
  
  
  
  
  
  
  
  

Name and address of
From
 To
Beginning
Ending
Reason for Leaving
 Name of
Full time
 Part time
company and
Mo./Yr.
 Mo./Yr.
 rate of pay
 rate of pay
  
 supervisor
    
type of business
  
  
  
  
  
  
  
  
 
 Describe the work you did in complete sentences:
 
  
  
 
  
              
 
  
              
Phone
  
  
  
  
  
  
  
  

Name and address of
From
 To
Beginning
Ending
Reason for Leaving
 Name of
Full time
 Part time
company and
Mo./Yr.
 Mo./Yr.
 rate of pay
 rate of pay
  
 supervisor
    
type of business
  
  
  
  
  
  
  
  
 
 Describe the work you did in complete sentences:
 
  
  
 
  
              
 
  
              
Phone
  
  
  
  
  
  
  
  

ACKNOWLEDGEMENT

Sports Academy & Racquet Club is an equal opportunity employer. All applicants are considered for positions without regard to race, color, religion, sex, national origin, age, or veteran status, or the presence of a non-job related medical condition or handicap.  Verification of eligibility to work in the U.S. will be required if an employment is made.

I acknowledge that consideration for employment is contingent on the results of a credit reference, criminal, drug, and background check.  I hereby authorize Sports Academy& Racquet Club to (1) conduct any and all of the above; (2) investigate the truthfulness of all statements made on this application; (3) contact my former employers and other listed references or any other persons who can verify information; and (4) discuss the results of any investigation with other employees of Sports Academy & Racquet Club involved in the hiring process.  In addition, I give my consent for all contacted persons including former employers to provide the information concerning this application, and I release each such person from liability for providing information to the company.
I certify that the information contained in this application is correct to the best of my knowledge, and understand that falsification of this application is any detail is grounds for disqualification from further consideration or dismissal from employment in accordance with company policy.

I understand that employment at this company is “at will” which means that either I or this company terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute.  All employment is continued on that basis.  I understand that no supervisor, manager, or executive of this company, other than the President has any authority to alter the foregoing.

____________________________________________________________
Signature                                                                    Date