Blacksburg Country Club Employment Application

Please fill out this application. Qualified applicants will be notified for an interview.

POSITION(S)

Select the position(s) you wish to apply for
First Choice:     

Second Choice:

Third Choice:    

Other:                  


PERSONAL INFORMATION

Full Name:               Prefered Name:  
Date of birth (mm/dd/yy):      

Address:          Apt #:
City:                State:         Zip:

E-mail Address:  

Home Phone:      Cell Phone:     

Social Security #: 

Under the Immigration and Control Act of 1986, you will be required to fill out a certification verifying that you are eligible to be employed and verifying your identity. Further, you will be required to provide documentation to that effect should you be employed. For purpose of compliance with The Immigration and Control Act, are you legally eligible for employment in the United States?
Yes    No

The Military Selective Service Act requires all male citizens of the United States and non-citizen males seeking citizenship between the ages of 18 and 25 to register for the Selective Service. You will be required to provide documentation should you be employed. For purposes of compliance with the Military Selective Service Act, have you registered for the Selective Service?
Yes    No

Do you have a valid drivers license?    Yes    No
Drivers License Number:   

Hours able to work per week:   
Date available to start work:      


EDUCATION
High School:
Number of years attended:     
School Name and Address:   
Did you graduate?    Yes    No

College:
Number of years attended:     
School Name and Address:   
Did you graduate?    Yes    No

Other:
Number of years attended:     
School Name and Address:   
Did you graduate?    Yes    No


EXPERIENCE

Please describe your most recent jobs. Highlight your knowledge, skills and abilities that best demonstrate your qualifications for this position.
May we contact your present supervisor? Yes    No

Most Recent:
Job Title:          Duties:   
Employer (Company name and Address):     
Supervisor (Name, Title, Phone Number):     
Reason for Leaving:   
Dates Employed:              Salary earned:   

Second Most Recent:
Job Title:          Duties:   
Employer (Company name and Address):     
Supervisor (Name, Title, Phone Number):     
Reason for Leaving:   
Dates Employed:              Salary earned:   


Please list any licenses, certificates, or other authorizations to practice a trade or profession
Include the Type, License number, Expiration Date, and the name of the licensing board it was granted by:
1.
2.


REFERENCES

Please list 3 references not related to you that know your qualifications
Include their Name, Address, Phone Number, and Relationship to you:
1.
2.
3.

By submitting this application you agree and attest the the following:
The information provided in this application for employment is true, correct and complete.  If you employ me, any misstatement or omission of fact on the application may result in my dismissal.  I understand that acceptance of an offer of employment creates no obligation upon you, the employer, to continue to employ me in the future.