EXPERIENCE - Old Sandwich Golf Club

Rev 2012
Old Sandwich Golf Club
EMPLOYMENT APPLICATION
The Old Sandwich Golf Club offers equal employment opportunity to all applicants for employment and all
employees regardless of sex, sexual orientation, age, race, color, religion, national ancestry, veteran status,
disability, genetic information or any other status protected by applicable law. An applicant who does not meet
the minimum qualifications of the position(s) for which the applicant applies will not be considered for
employment.
*Please print clearly and sign where indicated
PERSONAL DATA:
Name: _______________________
Last name
_____________________
____
_______________
First name
Initial
Familiar/Nickname
Telephone: Home ____________________________Mobile ______________________________
Present Address:
______________________________________________
__________________________ ________ _____________
Street Number/Name
City
State
Zip Code
Email Address: _____________________________________________
If you are under 18 years of age, could you furnish a work permit?
_____ yes _____ no
Are you legally authorized to work in the United States?
_____ yes _____ no
If you are hired, will you be able to submit proof of the above?
_____ yes _____ no
Position(s) applied for: ______________________________________________________________________________
If position requires travel, do you have a valid driver’s license?
Dates Available:
_____ yes _____ no
Start ___________________________________ End ____________________________________
Hours Available: ___________________________________________________________________________________
EMPLOYMENT HISTORY:
Have you ever applied for employment with the Old Sandwich Golf Club?
_____ yes _____ no
If yes, when? ___________ How did you hear about us? ____________________________________________________
Are you presently employed?
_____ yes _____ no
Have you ever been discharged from a position?
_____ yes _____ no
If yes, please provide details (when and reason for discharge):
__________________________________________________________________________________________________
Employment history continued on back ...
List all of your places of employment beginning with the most recent. You may include work performed on a volunteer
basis. Please account for any time period between positions when you were not working. The Old Sandwich Golf Club
may contact any of these persons or entities for an employment reference.
Name and Address of Employer:
Telephone:
_______________________________________________________________________________________________
From _____ /_____ To_____ /_____ Manager/Supervisor ______________________Telephone ________________
Describe your Job Duties/Responsibilities:
_______________________________________________________________________________________________
Starting Salary: $ ________ Per ________
Ending Salary: $ ________ Per ________
Name and Address of Employer:
Telephone:
_______________________________________________________________________________________________
From _____ /_____ To_____ /_____ Manager/Supervisor ______________________Telephone ________________
Describe your Job Duties/Responsibilities:
_______________________________________________________________________________________________
Starting Salary: $ ________ Per ________
Ending Salary: $ ________ Per ________
Name and Address of Employer:
Telephone:
_______________________________________________________________________________________________
From _____ /_____ To_____ /_____ Manager/Supervisor ______________________Telephone ________________
Describe your Job Duties/Responsibilities:
_______________________________________________________________________________________________
Starting Salary: $ ________ Per ________
Ending Salary: $ ________ Per ________
Name and Address of Employer:
Telephone:
_______________________________________________________________________________________________
From _____ /_____ To_____ /_____ Manager/Supervisor ______________________Telephone ________________
Describe your Job Duties/Responsibilities:
_______________________________________________________________________________________________
E
XPERIENCE: (Please circle any prior experience)
E
XPERIENCE: (Please circle any prior experience)
Starting Salary: $ ________ Per ________
Ending Salary:
$ ________ Per ________
EXPERIENCE (please circle any prior experience):
Management
Front Desk
Sales/Promotions
Maid Services
Maintenance
Management
Front Desk
Sales / Promotions
Maid Services
Maintenance
Line Cook
Server
Banquets
Busser
Bartender
Dishwasher
Groundskeeper
Golf
Valet
Additional Experience: _____________________________________________________________________________
__________________________________________________________________________________________________
Qualifications /Special Training (i.e.T.I.P.S, ServSafe) ________________________________________________________
__________________________________________________________________________________________________________
EDUCATION AND TRAINING:
NAME OF SCHOOL & ADDRESS
YEARS
ATTENDED
COURSE OF STUDY/MAJOR
DIPLOMA /DEGREE
Please list any awards or honors: ______________________________________________________________
PERSONAL AND PROFESSIONAL REFERENCES (please do not list relatives):
NAME, OCCUPATION AND
RELATIONSHIP TO YOU
ADDRESS
TELEPHONE NUMBER
STATEMENT OF UNDERSTANDING:
CERTIFICATION (PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY):
I hereby certify and affirm that the information provided in conjunction with the application process, including the
information provided on this Employment Application and any resume submitted is true, accurate, and complete and
that I have withheld nothing that would, if disclosed, affect this application unfavorably.
I hereby authorize the Old Sandwich Golf Club to investigate all information pertinent to my Application for
Employment in order to determine my qualifications for employment which will include contacting former and/or
current employers or any other person or entity listed on this application. I hereby authorize all persons and entities
having information relevant to my application to provide that information to the Old Sandwich Golf Club and release
them from any liability arising out of or as a result of the request for, provision of, or use of such information. I
understand that any offer of employment may be rescinded or my employment terminated if my references are
inadequate or unacceptable to the Old Sandwich Golf Club or if I violate any of the provisions of this Certification. I
further understand that if I am hired by the Old Sandwich Golf Club, I must abide by all the rules and policies of the
Old Sandwich Golf Club which, other than the “at will” employment policy, may be changed without notice at the
discretion of the Old Sandwich Golf Club.
I understand that completion of this Application for Employment does not assure me of a position with the Old
Sandwich Golf Club. I also understand that neither this application nor any other document constitutes a contract for
employment for a specific term and that any employment relationship that may be established will be “at will”. As
such, any employment relationship I may have with the Old Sandwich Golf Club may be terminated at any time, for
any reason or no reason, by me or the Old Sandwich Golf Club.
I understand that any omission, misrepresentation, or falsification in conjunction with this application process may
be grounds for denial of employment, or, if hired, immediate termination of employment.
Massachusetts General Laws c.149 s19B requires that the following statement be included on employment
applications: “It is unlawful in Massachusetts to require or administer a lie detector test as a condition of
employment or continued employment. An employer who violates this law shall be subject to criminal and civil
liability.”
Massachusetts General Laws c.151B defines “genetic information” as any written record or explanation of a genetic
test of a person’s family history with regard to the presence, absence, or variation of a gene. A genetic test is
broadly defined as “any test of DNA, RNA, mitochondrial DNA, chromosome or proteins for the purpose of
identifying genes or genetic abnormalities.” The law expressly excludes drug and alcohol test from this definition,
meaning that employers may continue to conduct such tests in accordance with existing legal requirements.
These new statutory provisions specifically prohibit employers from (1) terminating or refusing to hire individuals
on the basis of genetic information; (2) requesting genetic information concerning employees, applicants or their
family members; (3) attempting to induce individuals to undergo genetic tests or otherwise disclose genetic
information; (4) using genetic information in anyway that affects the terms and conditions of an individual’s
employment; or (5) seeking, receiving or maintaining genetic information for any non –medical purpose.
Today’s Date ____/____/____ Applicant’s Signature: ___________________________________________
Old Sandwich Golf Club
JOB REFERENCE WAIVER
Applicant’s Name (print) _____________________ ________________
First
Middle
_______________________
Last
I hereby authorize the Old Sandwich Golf Club to investigate all information pertinent to my Application for Employment
in order to determine my qualifications for employment which will include contacting former and/or current employers or
any other person or entity listed on this application. I hereby authorize all persons and entities having information
relevant to my application to provide that information to the Old Sandwich Golf Club and release them from any liability
arising out of or as a result of the request for, provision of, or use of such information. I understand that any offer of
employment may be rescinded or my employment terminated if my references are inadequate or unacceptable to the Old
Sandwich Golf Club or if I violate any of the provisions of this Certification.
Applicant’s Signature (sign) ______________________________________ Date ______ / ______ / ______
The above named individual has applied for a position with our company. She/he authorizes Old Sandwich Golf Club to
secure relevant information about their employability with our organization.
Please provide the following information and feedback:
Dates of Employment: ___________________ to __________________ Position Held: _________________
Is s/he eligible for Re-Hire? Yes ______ No ______ Final rate of pay? _____________ per hour/week/annual
Please rate the candidate in the following areas: (mark with an “X”)
Job Performance:
Excellent ___ Good ___ Fair ___ Poor ____
Work Ethic/Productivity:
Excellent ___ Good ___ Fair ___ Poor ____
Attendance/Reliability:
Excellent ___ Good ___ Fair ___ Poor ____
Attitude/Willingness:
Excellent ___ Good ___ Fair ___ Poor ____
Team Player:
Excellent ___ Good ___ Fair ___ Poor ____
Responsibilities:_________________________________________________________________________
What have I not asked that might be useful to know about this individual?___________________________
______________________________________________________________________________________
Additional comments: _______________________________________________________________________
__________________________________________________________________________________________
Reference Name and Title:_________________________________________ Date ______/______ / _____
Old Sandwich Golf Club ~ 41 Doublebrook ~ Plymouth, MA 02360 ~ Phone 1-508-209-2200 ~ Fax 1-508-209-2299