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Employment Application - Title
Application For Employment
Form Designer
DummyValue
ABOUT YOU
First Name:
*
Last Name:
*
Nickname:
Phone:
Email Address:
Street Address:
City:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Mailing Address:
City:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
If you listed a message phone above, how often do you check for messages?
Name of person to contact in case of emergency:
Phone:
Do you have reliable transportation to meet any scheduled shift?
Can you read at a 6th grade level?
Have you been convicted of a felony?
If yes, please give details:
Have you ever worked for us before?
If so, under what name?
Do you have any friends or relatives working for us?
Who?
Can you provide proof that you are over 18 years old?
Over 21 years old?
Are you a smoker?
Do you have a valid driver’s license?
Class:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
License No.
Have you had any accidents or moving violations in the past three years?
If yes, please provide details:
Have you ever been bonded?
Is there any reason why you could not be bonded?
If yes, please give details:
Do you have a legal right to work in the U.S.?
Can you provide documentation of your legal right to work?
Is additional information concerning change of name necessary to check work or education records?
If yes, please explain (continue on last page if necessary).
ABOUT THE JOB
For what position are you applying?
Salary Requirement: $
per
Would you accept another position?
If so, which one?
Which do you prefer?
--Select--
Full-time work
Part-time work
--Select--
Full-time work
Part-time work
If part-time, about how many hours per week?
Which will you accept?
--Select--
Full-time work
Part-time work
--Select--
Full-time work
Part-time work
When could you start working for us full-time?
When are you available to work for us full-time?
Mon
Morning
Afternoon
Evening
Can work anytime
Tue
Morning
Afternoon
Evening
Can work anytime
Wed
Morning
Afternoon
Evening
Can work anytime
Thu
Morning
Afternoon
Evening
Can work anytime
Fri
Morning
Afternoon
Evening
Can work anytime
Sat
Morning
Afternoon
Evening
Can work anytime
Sun
Morning
Afternoon
Evening
Can work anytime
When could you start working for us part-time?
When are you available to work for us part-time?
Mon
Morning
Afternoon
Evening
Can work anytime
Tue
Morning
Afternoon
Evening
Can work anytime
Wed
Morning
Afternoon
Evening
Can work anytime
Thu
Morning
Afternoon
Evening
Can work anytime
Fri
Morning
Afternoon
Evening
Can work anytime
Sat
Morning
Afternoon
Evening
Can work anytime
Sun
Morning
Afternoon
Evening
Can work anytime
EDUCATIONAL DATA
High School (Name)
Street Address:
Number:
City:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
No. of Years Completed:
Degree:
Major Course of Study:
College (Name)
Street Address:
Number:
City:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
No. of Years Completed:
Degree:
Major Course of Study:
Graduate School (Name)
Street Address:
Number:
City:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
No. of Years Completed:
Degree:
Major Course of Study:
Trade, Business, Night, or Corres.
Street Address:
Number:
City:
Zip:
No. of Years Completed:
Degree:
Major Course of Study:
Other
Street Address:
Number:
City:
State:
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
No. of Years Completed:
Degree:
Major Course of Study:
Other skills: List any other job-related skills, qualifications, or licenses that support your application
Honors received:
In order to permit a check of your work and educational work records, should we be made aware of any changes of name or assumed name that you previously used?
Yes
No
If yes, identify names and relevant dates.
EMPLOYMENT EXPERIENCE
List each job held. Start with your present or last job. Include military experience. If known by any other name, please indicate.
Employer:
From Date
To Date
Address:
Job Title:
Salary Start:
Salary Final:
Supervisor:
Reason For Leaving:
Work Performed:
May we make inquiries of this employer?
--Select--
Yes
No
--Select--
Yes
No
EMPLOYER 2
Employer:
From Date
To Date
Address:
Job Title:
Salary Start:
Salary Final:
Supervisor:
Reason For Leaving:
Work Performed:
May we make inquiries of this employer?
--Select--
Yes
No
--Select--
Yes
No
EMPLOYER 3
Employer:
From Date
To Date
Address:
Job Title:
Salary Start:
Salary Final:
Supervisor:
Reason For Leaving:
Work Performed:
May we make inquiries of this employer?
--Select--
Yes
No
--Select--
Yes
No
EMPLOYER 4
Employer:
From Date
To Date
Address:
Job Title:
Salary Start:
Salary Final:
Supervisor:
Reason For Leaving:
Work Performed:
May we make inquiries of this employer?
--Select--
Yes
No
--Select--
Yes
No
Membership in Organizations and/or Professional groups which, in your opinion, have a direct bearing on the position you are seeking.
Are you a veteran of the U.S. Military Service?
--Select--
Yes
No
--Select--
Yes
No
If yes, which branch of Service?
If yes, beginning date and ending date of active duty:
From:
To:
Date of Discharge from Military Service:
NOTICE TO APPLICANTS
We comply with the Americans With Disabilities Act of 1990. During the interview process, you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment, you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, all entering employees in the same job category will be subjected to the same medical questionnaire and/or examination and all information will be kept confidential and in separate files.
We are an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, sex, religion, national origin, handicap, or marital status. We assure you that your opportunity for employment with this Employer depends solely upon your qualifications.
PLEASE READ AND SIGN STATEMENT BELOW
I understand that, in accordance with Florida Statute §443.131(3)(a)(2), if hired, I will be placed on a 90-day probationary period. I further understand that if I am terminated for unsatisfactory work performance within the 90-day probationary period, the employer may seek to contest any unemployment benefits I might attempt to obtain as a result of my termination
Full Name:
I understand and agree that all policies, procedures, and the Employee Handbook may be modified, amended, or deleted by the Club with or without notice to me of such amendment, modification or deletion; that the policies and procedures are not intended to be a contract of employment nor do they give me a right of continued employment; and that my employment may be terminated at my option or at the option of the Naples Yacht Club, Inc. with or without notice by either party. I also understand that there are no other arrangements, agreements, or understandings regarding the terms of employment. There may be no amendments or exceptions to this statement unless they are in writing and signed by the Commodore.
Full Name:
I certify that all information given on this employment application; any résumé that I submit to the Club; and any related papers and answers given during oral interviews are true and correct. I understand that the Naples Yacht Club, Inc. will make a thorough investigation of my work and personal history. I authorize the giving and receiving of such information requested by the Club during the course of such an investigation. I understand that falsification of any information given by others during the course of an investigation or any derogatory information discovered as a result of this investigation may subject me to immediate dismissal. I hereby release from liability all persons who provide information to my employer during the course of such any such investigation. I hereby release any liability arising under the Fair Credit Reporting Act.
Full Name:
Date:
Signature:
Additional Detailed Information
Additional Detailed Information
Submit