New Employment Application Please complete the application below. All questions can be directed to The Greenwich Club general manager at thegreenwichclubmanager@gmail.com 1Applicant Info2Position3Certifications4Employment History5Parent/Guardian Authorization6For Club Use ONLY Name* First Last Cell PhoneHome PhoneAddress Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Birth Date MM slash DD slash YYYY Social Security Number List Any Friends or Family Employed by The Greenwich Club Check Last Grade Completed High School Freshman High School Sophomore High School Junior High School Senior College Freshman College Sophomore College Junior College Senior Trade School 1 Year Trade School 2 Year Name of and Date of Last School Attended PositionPosition(s) Applying For/Desired: If Hired, Can You Provide Proof of Employment Eligibility? Yes No Are there any days/hours you CANNOT work? If so, which ones? What, if any, vacation time do you anticipate for this summer?ANY JULY TIME OFF MUST BE PRE-APPROVED BY GENERAL MANAGER PRIOR TO HIRE DATE. Are you willing to work holidays/overtime as required? Date You Can Start Work Date You MUST Stop Working Certifications (If Applicable)Please check any additional training and certification held (Documentation will be required if applicable) First Aid CPR Lifesaving Water Safety Instructor S.T.O.P. Safe Serve Other Certification/License Uploads (If available)Documentation / CertificationUpload a PDF certification and documentation here (If Applicable)Max. file size: 20 MB.Lifeguard Certification or Aqua Aerobics CertificationUpload a PDF of your lifeguard or Aqua Aerobics certification here. (If Applicable)Max. file size: 20 MB.Certification DateEnter either the expiration date of your current lifeguard certification or the completion date of a future certification. (If Applicable) MM slash DD slash YYYY Pool Operator’s LicenseUpload a PDF file of your pool operator's license here. (If Applicable)Max. file size: 20 MB.License DateEnter either the expiration date of your current pool operator's license or the completion date of a future license. (If Applicable) MM slash DD slash YYYY Employment HistoryCurrent or Most Recent Employer Name Currant or Most Recent Employer Phone NumberCurrent or Most Recent Employer Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current or Most Recent Employer Job and Rate of Pay Current or Most Recent Employer Reason for Leaving Current or Most Recent Employer Dates Started and Ended Previous Employer Name Previous Employer Phone NumberPrevious Employer Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Previous Employer Job and Rate of Pay Current or Most Recent Employer Reason for Leaving Previous Employer Dates Started and Ended May we contact your current/previous employer? Yes No References: Provide Name, Address, Phone Number and RelationshipSignature*By signing this application I understand that, as a condition of my employment, I will adhere to The Greenwich Club's Rules and Regulations along with the employee handbook. I understand that any violation of these policies and rules, may result in the termination of employment. I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of the facts called for is cause for dismissal. Further, I understand and agree that my employment is contingent upon BCI check and approval, and for no definite period, and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice, with or without cause. Any contraband, controlled substances, alcohol, drugs on The Greenwich Club premises will be grounds for immediate and final dismissal. Parent/Guardian AuthorizationParent/Guardian AuthorizationApplicants under age 18 must supply parent/guardian name and contact information to be considered.Parent/Guardian Name First Last Parent/Guardian Phone NumberContact in Case of EmergencyName, Phone Number, Address and Relationship Interviewed By and Date Hired Yes No Postion and Wage Start Date BCI Results and Date Documentation Provided and Notes
