Boca West Master Association, Inc.
20540 Country Club Boulevard, Suite 105 · Boca Raton, FL 33434-4202
Telephone (561) 488-1598 · Fax (561) 487-5531
Personal Information
First Name______________________ Middle Initial_______ Last Name___________________________
Street Address_________________________________________________________________________
City _____________________________________________________ State________ Zip Code________
Home Phone_____________________ Mobile Phone _______________________
Email Address________________________________________________________
Social Security Number _____________________________
Are you eligible to work in the U.S.?____________________
A Have you ever been previously employed by Boca West Master Association? Yes
No
Explain_____________________________________________________________________________________
Do any of your friends or relatives work here? Yes
No
If Yes, Who? _________________________________
Are you at least 18 years or older? _____________________
Have you ever been convicted of a crime within the last 7 years?
If yes, please explain:__________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Are you able to perform the essential functions of the job for which you were applying, with or without a
reasonable accommodation? Yes No (Do not answer this question unless you have been informed about the
requirements of the job for which you are applying.)
Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
Yes No (Proof of citizenship or immigration status will be required upon employment)
Employment Desired
Date available for work______________________________ Hourly Rate/Salary Desired_________________
Position desired____________________________________________________________________________
Are you currently employed? Yes No
Can you Work: Full Time
Part Time
May we contact your present employer? Yes
Shift 1
Shift 2
Shift 3
No
Weekends
Overtime
Referral Source
How did you hear about us? ___________________________________________________________________
Employment History
Include your last seven (7) years of employment history, including periods of unemployment, starting with the
most recent. Incomplete information may disqualify you from further consideration.
From: _____________ To:_____________ Job title:_________________________________________________
Employer Name_________________________________________________ Telephone___________________
Employer Address____________________________________________________________________________
Immediate supervisor and title: ____________________________________________________
Briefly summarize the nature of work performed and job responsibilities:
__________________________________________________________________________________________
Reason for leaving: __________________________________________________________________________
Hourly rate/salary: ___________________
From:_____________ To:_____________ Job title:_________________________________________________
Employer Name_________________________________________________ Telephone___________________
Employer Address____________________________________________________________________________
Immediate supervisor and title: ____________________________________________________
Briefly summarize the nature of work performed and job responsibilities:
__________________________________________________________________________________________
Reason for leaving: __________________________________________________________________________
Hourly rate/salary: ___________________
From: _____________ To:_____________ Job title:_________________________________________________
Employer Name_________________________________________________ Telephone___________________
Employer Address____________________________________________________________________________
Immediate supervisor and title: ____________________________________________________
Briefly summarize the nature of work performed and job responsibilities:
__________________________________________________________________________________________
Reason for leaving: __________________________________________________________________________
Hourly rate/salary: ___________________
From: _____________ To:_____________ Job title:_________________________________________________
Employer Name_________________________________________________ Telephone___________________
Employer Address____________________________________________________________________________
Immediate supervisor and title: ____________________________________________________
Briefly summarize the nature of work performed and job responsibilities:
__________________________________________________________________________________________
Reason for leaving: __________________________________________________________________________
Hourly rate/salary: ___________________
Have you ever been terminated from employment or asked to resign by an employer?______________
If Yes, please provide company name and details below.
Company Name_________________________ Terminating Manager’s Name_____________________
Reason for Termination or resignation_____________________________________________________
Name and location of school
Education
High School
College or
University
Trade, business,
or
correspondence
school
Number
of years
attended
Degree
Subjects
received studied/major
_____________________________________ ________ _______
____________
_____________________________________ ________ _______
____________
_____________________________________ ________ _______
____________
Do you have any special skills, experience and or training that would enhance your ability to perform the
position applied for? If yes, please explain
______________________________________________________________________________
List three references other than relatives
Name
1
2
3
Address, Phone, Email
Company
Years
Acquainted
_____________________________________ _____________________
_______
_____________________________________ _____________________
_______
_____________________________________ ____________________
_______
Please read carefully before signing.
I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application for employment as may
be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed
45 days. Any applicant wishing to be considered for employment beyond this time period
should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any
employment relationship with this organization is of an "at will" nature, which means that the
Employee may resign at any time and the Employer may discharge Employee at any time with
or without cause.
In the event of employment, I understand that false or misleading information given in my
application or interview(s) may result in discharge. I understand, also, that I am required to
abide by all rules and regulations of the employer.
Please date & this application below.
___________________________________________________________
Signature
_____________________
Date
THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE SIGNED AND DATED ABOVE.
Arrange Interview: Yes
No
Remarks _____________________________________________________________________
______________________________________
INTERVIEWER
Employed: Yes
No
__________________________________
DATE
Date of Employment_______________________________________
Job Title _____________________Hourly Rate/Salary__________ Department ____________
By _________________________________________________ _______________________
NAME AND TITLE
DATE