Employment Application Form

To Applicant: If you need assistance in completing this application, please let us know. We deeply appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will aid us in considering you for the position that best matches your qualifications. Therefore, we encourage you to be as complete and specific as possible. In this application we are sometimes referred to as The Club. The Club is an equal opportunity employer. The Club will not discriminate unlawfully against any employee or applicant for employment because of race, sex, creed, color or religion, national origin, age, marital status, physical or mental disabilities or status as disabled or Vietnam-era Veteran, when the individual is otherwise qualified. The Club will strive to provide a safe and healthful work environment, free of substance abuse, for the protection and safety of our employees, members and guests.
This application will remain active for 90 days.

Personal Information

Last Name:  First Name: Middle Name 
Social Security Number:                Email Address: 

Present Address: Telephone Number:  

How many years at this address? 

Are you legally eligible for employment in the United States? YesNo
If hired, can you furnish proof? Yes  No

Position(s) you are primarily interested in:
  1. Rate of Pay expected  per hour  week  month
  2. Rate of Pay expected  per hour  week  month

Please choose an employment type below:

Were you previously employed by us? Yes  No   If so, when 

If hired, on what date will you be able to start work? 

What hours and days of the week will you be able to work? 

Military Service Record

Were you in the U.S. Armed Forces? Yes  No  If yes, what branch? 

Dates of Duty: From  to 

Rank at Discharge: 

List Duties in the service, including special training which relates to the position you are seeking: 
Are you presently in the U.S. Armed Forces Reserve? Yes No 

In Case of Emergency Notify

Name:    Phone: 

Character References
Do not refer to casual acquaintances, previous employers or relatives. Refer to three people whom you know well either personally or in business.

1. Name:   Phone:   Number of Years Known: 

2. Name:   Phone:   Number of Years Known: 

3. Name:   Phone:   Number of Years Known: 


Highest Grade Completed:  High School    College  

Name of High School:   Location: 

Did you graduate? Yes  No   
If NOT a high school graduate, do you have an equivalency diploma? Yes  No 

College/Graduate School

1.Name and Location:   From:  To: 

Degree:   Major:   GPA:   Credits:  

Extracurricular Activities, Honors:

Other training or special studies:   

List current professional licenses and registrations: 

2.Name and Location:   From:   To: 

Degree:   Major:   GPA:   Credits: 

Extracurricular Activities, Honors:

Job Abilities
Indicate job skills you've acquired and equipment you can operate which pertains to the job for which you are applying. Include amount of experience.

What qualifications, abilities and strong points will help you succeed in this job?

If required in the job for which you are applying:
Do you have a valid driver's license? Yes  No   Can you furnish proof? Yes  No 
State & License Number: 

Has your driver's license ever been suspended or revoked ? Yes  No 
If yes, explain in full: 

Work History
Please give accurate, complete full-time and part-time employment record. Start with present or most recent employer. Please email additional pages if necessary. Show unemployed or self-employed periods; indicate dates of each and explain. All time must be accurately and truthfully accounted for. If you have emailed your resume to us, you do not need to fill out this section. Please type "See Resume" in a box below.
Note: you need not explain any gaps in employment related to a disability or rehabilitation.

1. Company Name:   Phone:  


Employed(Month/Year) From:  To:   Weekly Pay: 

Name & Title of Supervisor: 

State Job Title and describe in detail the work you did:

Reason for Leaving: 

2. Company Name:   Phone: 


Employed(Month/Year) From:  To:   Weekly Pay: 

Name & Title of Supervisor: 

State Job Title and describe in detail the work you did:

Reason for Leaving: 

3. Company Name:   Phone: 


Employed(Month/Year) From:   To:   Weekly Pay: 

Name & Title of Supervisor: 

State Job Title and describe in detail the work you did:

Reason for Leaving: 

To The Applicant

Have you ever been discharged or asked to resign? Yes  No  If yes, please explain in full: 

Have you ever been convicted of or plead guilty or no contest to or had adjudication withheld with a felony or misdemeanor? Yes  No       
On Probation?  Yes  No         Criminal Charges Pending? Yes  No 
If yes to either, describe in full (including dates) NOTE: Convictions or guilty pleas or withheld adjudications are not an automatic bar to employment. All circumstances will be considered.

Have you ever been refused a bond by an employer? Yes  No 

Have you ever had shortages or misunderstandings about merchandise or funds at a place of employment?
Yes  No   If yes, explain in full: 

I hereby certify that the facts set forth in the application are true and complete, and I agree that you may investigate my statements in order to verify and expand upon the information given.

I understand that as part of normal employment procedure, inquires may be made concerning information on my former job responsibilities, character, general reputation and credit. I authorize such investigation and hereby agree to fully cooperate in this investigation.  I release you and all named former employees, all character references and credit sources, from any liability for releasing information to you.

I understand that if I fail to answer any question, or if I give misleading or incomplete answers to any questions, that along is sufficient basis for a failure to hire me, or if I have been hired, that along is sufficient for my immediate termination.

I further understand that this is an application for employment and that no employment contract is being offered. I agree and acknowledge that should I become employed by the Club, my employment can be terminated, with or without cause or notice, at any time by myself or the Club.

I have had a full opportunity to ask whatever questions I have about the above statement.

Date:      Applicant's E-Signature: 

Drugfree Workplace - Pre-Employment Drug Testing Policy
All applicants if hired at Bald Peak Colony Club will undergo a drug screening to determine the presence of illegal drugs as a condition of employment.

Applicants will be asked to voluntarily submit to a urinalysis test and to sign a consent agreement releasing the Club from any liability.

Any applicant who refuses to submit a drug screening, or who tests positive for illegal drugs will be denied employment at that time.

The Club will not discriminate against applicants for employment because of past abuse of drugs. It is the current abuse of drugs which prevents employees from properly performing their jobs that the Club will not tolerate.

Bald Peak Colony Club shall provide technical assistance to the Medical Review Officer or applicant for the purpose of interpreting positive test results which could have been caused by prescription or non-prescription medication taken by the applicant.

Date:   Applicant's E-Signature: 

Please be sure to also sign and email the Background Check Disclosure form located on the Application Page.