| |
Come back soon to apply on-line
or
to print out an
application and apply in person
You may download an application by right clicking on the following
links
and in IE selecting "Save Target as"
Word
Document
Rich
Text Format - this should be printable in most word processing programs
To print out an application
 Ultimate Water Massage
EMPLOYMENT APPLICATION
We consider applicants for all positions without regard to race, color,
Religion, gender, national origin, age, marital or veteran status,medical
condition, disability, or any other legally protected status.
PLEASE PRINT
|
Position(s) Applied For
|
Date of Application |
|
How Did You Learn About Us?
|
|
First Name Middle Name Last Name
|
|
Present Address City State Zip Code
|
|
Permanent Address City State Zip Code
|
|
Telephone Number(s)
|
Social Security Number
| | |
Are you 16 yrs of age or older? Y/N |
Ø Have you ever filed an application
with us before? Y/N If yes, date and location_________________
Ø Have you ever been employed with us
before? Y/N If yes, date and location ________________
Ø Are you prevented from lawfully
becoming employed in this country because of Visa or immigration status?
(Proof of citizenship or immigration status will be required upon
employment) Y/N
Ø Have you been convicted of a crime?
Y/N If yes, list convictions_________________________
|
List 3 Personal References (professional relationship
suggested) who are not related to you and are not previous employers. |
|
Name, Occupation and Relationship |
Address |
Phone Number |
| |
|
|
| |
|
|
| |
|
|
|
Education
|
High School |
Undergraduate College/University |
Graduate |
|
School Name/Location |
|
|
|
|
Yrs Completed (Circle) |
9 10 11 12 |
1 2 3 4 |
1 2 3 4 |
|
Diploma/Degree |
|
|
|
|
Describe Course of Study
(Honors, Specialized Training & activities) |
|
|
|
Ø On what date would you be available
for work?___________
Ø Are you available to work:
Full-time Y/N Part-time Y/N
Ø Total hours available per
week____________
|
Identify below the specific hours you are available to
work per week (indicate am/pm). |
| |
Sunday |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
|
From |
|
|
|
|
|
|
|
|
To |
|
|
|
|
|
|
|
Ø List any extracurricular
activities which might affect your
schedule:___________________________________________________________________
Ø Are you presently employed? Y/N
If yes, may we contact this employer? Y/N
If not employed, how long have you been unemployed? _____Yrs
_____Months
Ø How many jobs have you had in the
past 5 Yrs? _____
Ø Did you ever leave a job because
you might have been fired if you did not quit? Y/N
Ø If yes, which jobs?
__________________________________________________________
Ø In the past 5 years, how many
times have you been fired or asked to resign?___
Please explain each situation
________________________________________________
Ultimate Water Massage EMPLOYMENT APPLICATION / CONTINUED
|
Start with your present or last job, and list in consecutive order the
last 3 previous jobs held . Account
for any time during this period that you were unemployed by stating the
nature of your activities. Include any job-related military assignments
and volunteer activities. You may exclude organizations which indicate
race, color, religion, gender, national origin, handicap or other
protected status.
|
|
Employer
|
Dates Employed
From | To |
Work Performed
(Include promotions & achievements) |
|
Address
|
|
|
|
|
Telephone Number(s)
|
Hourly Rate/Salary
Starting|Final |
|
|
Job Title
|
Supervisor |
|
|
|
|
Reason for Leaving
|
Hours worked weekly
|
Rrences checked by:_________ |
|
Employer
|
Dates Employed
From | To |
Work Performed
(Include promotions & achievements) |
|
Address
|
|
|
|
|
Telephone Number(s)
|
Hourly Rate/Salary
Starting|Final |
|
|
Job Title
|
Supervisor |
|
|
|
|
Reason for Leaving
|
Hours worked weekly
|
References checked by:_________ |
|
Employer
|
Dates Employed
From | To |
Work Performed
(Include promotions & achievements) |
|
Address
|
|
|
|
|
Telephone Number(s)
|
Hourly Rate/Salary
Starting|Final |
|
|
Job Title
|
Supervisor |
|
|
|
|
Reason for Leaving
|
Hours worked weekly
|
References checked by:_________ |
|
Please identify any other jobs, part-time and full-time, you have held
in the past five years:
|
I certify that the answers given herein are true and complete to the best of
my knowledge. I authorize investigations of all statements contained in this
application for employment as may be necessary in arriving at decision,
including current and past an employment employment, education, and
release from liability all persons, companies, corporations, and schools
supplying that information. I hereby understand and acknowledge that, unless
otherwise defined by applicable law, any employment relationship with Ultimate
Water Massage 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. It is further understood that this "at will"
employment relationship may not be changed by any written document or by conduct
unless such change is specifically acknowledged in writing by an authorized
executive of this organization. Additionally, I understand that nothing
contained in the employment application or in the granting of an interview is
intended to create a contract between Ultimate Water Massage and myself for
either employment or for the providing of any benefit arising from employment.
In the event of employment, I understand that ay falsification or omission of
information given in my application or interview(s), is immediate grounds for
dismissal. I understand, also, that I am required to abide by all rules and
regulations of Ultimate Water Massage.
Date_________ Signature of Applicant___________________________________
|
