The Walden Club, LLC – Employment Application
We are an equal opportunity employer. We are dedicated to a policy of non-discrimination in employment on any basis including race, creed, color,
age, sex, religion, national origin or disability.
Personal Information
Name
Phone
Number
Last
First
Middle
Present Home Address
S.S. # -
-
How did you hear about Walden Club?
Ever convicted of a felony?
If so,
explain
Drivers License Number
Expiration
State
Ever work at Walden Club before?
Position
& dates
Are you 18 years old or older? Yes
No
Type of work desired
Hours & days available
Education
High School
Years Did you graduate?
College #1
Years Degree earned
College #2
Years Degree earned
College #3
Years Degree earned
Other
Years Certifications
Other
Years Certifications
References
Give the names of persons who are able to give an
estimate of your character and fitness for the position for which you are applying.
Do not include previous employers who are listed below.
Name
Telephone
Occupation
Name
Telephone
Occupation
Name
Telephone
Occupation
Name
Telephone
Occupation
Work Experience
Provide information for your last 5 positions. You must give a reason for leaving each position.
Most Recent Employment
Dates
Name of Company
Location
Position held
Supervisor
Phone
Wages earned
Reason
for leaving
Next Most Recent Employment
Dates
Name of Company
Location
Position held
Supervisor
Phone
Wages earned
Reason
for leaving
Next Most Recent Employment
Dates
Name of Company
Location
Position held
Supervisor
Phone
Wages earned
Reason
for leaving
Next Most Recent Employment
Dates
Name of Company
Location
Position held
Supervisor
Phone
Wages earned
Reason
for leaving
Next Most Recent Employment
Dates
Name of Company
Location
Position held
Supervisor
Phone
Wages earned
Reason
for leaving
I
understand, acknowledge and agree that nothing in this employment application creates an implied or express contract of employment
between The Walden Club, LLC (hereafter referred to as Company), and me. If I
am hired by the Company, I agree and acknowledge that my employment will be “at will” and thus can be terminated
by the Company at any time with or without cause and with or without notice. I
also acknowledge and agree that no one at the Company has the authority to make any employment agreement with me other than
the President of the Company, either orally or in writing, that is not an “at will” agreement as is described
in this paragraph. The undersigned hereby authorizes the Company and/or its agents
to verify all statements and representations made in this application. I fully
understand that any misrepresentation or omissions of fact may be cause for dismissal.
I further understand and agree that polygraph examinations and drug testing may be required by the Company of its employees,
and I agree to submit to any polygraph examination and drug testing upon request by the Company. The undersigned hereby agrees to submit to a lie detector test and/or drug test given with the authorization
of the Company. I understand that by Federal Law, I can be requested to take
a lie detector test whenever theft occurs and is within my location of employment and that it is possible that, because I
had access, I may be involved. The test will always be administered by an outside
agency to ensure that the employee will always be treated in a fair and objective manner.
Date
Signature of Applicant
