Employment Application


Employment ApplicationCollapse

Full Legal Name :
Today's Date :

An Equal Opportunity EmployerCollapse

Position(s) Applied for :
Date of Application :
Full Legal Name (Do not use nicknames) :
Address :
House / Apt # :
City :
State :
Zip Code :
Home Phone Number :
Cell Phone Number :
Email address :
Have you ever been employed here before ?
If Yes, List dates : From
To :
Please include reason for leaving :
Have you ever applied for work here ?
If yes, when :
Do you have a relative employed here ?
If yes, please include name :
List your referral source How did you hear about the job ?
Are you age 18 or older ?
Type of employment desired :
Are you related to a VCC member ?
If yes, please include member name :
Date(s) available for work (when can you start) :
Are you able to meet the attendance requirements of the position ?
Have you been convicted of a felony in the past seven (7) years :
Please answer the following question if you are applying for a restaurant job : The Secretary of Health and Human Services has determined that certain diseases, including Hepatitis A, Salmonella, Shigella, Staphylococcus, Streptococcus, Giardia and Campylobacter may prevent you from serving food or handling food equipment in a sanitary or healthy manner. An essential function of this job involves handling and serving food, food service equipment and utensils in a sanitary and healthy manner. Is there any reason why you cannot perform the essential functions of this job ?
If yes, please explain :

Employment HistoryCollapse

List below your last three (3) employers, assignments or volunteer activities. Please start with your last or current employment, including military experience.

List most current or last employment first:

Name of Employer :
Phone :
Address :
City :
State :
Zip :
Direct supervisor's name and title :
Your job title :
Summary of your job duties :
Reason for leaving :
Dates employed From :
To :
Starting wage $ :
Ending wage $ :

Name of Employer :
Phone :
Address :
City :
State :
Zip :
Direct supervisor's name and title :
Your job title :
Summary of your job duties :
Reason for leaving :
Dates employed From :
To :
Starting wage $ :
Ending wage $ :

Name of Employer :
Phone :
Address :
City :
State :
Zip :
Direct supervisor's name and title :
Your job title :
Summary of your job duties :
Reason for leaving :
Dates employed From :
To :
Starting wage $ :
Ending wage $ :


List any Skills, Knowledge or Qualifications that you acquired from employment or other experiences that you feel may be relevant and of interest to Vestavia Country Club :

Education BackgroundCollapse

High School :
City :
State :
Did you graduate ?
College :
City :
State :
Did you graduate ?
Trade School :
City :
State :
Did you graduate ?
Other :
City :
State :
Did you graduate ?

REFERENCES – Do not list relatives, doctor, school personnel or former employer

Name :
Phone :
Years known :
Name :
Phone :
Years known :
Name :
Phone :
Years known :


PLEASE READ CAREFULLY BEFORE SIGNING
If you have any questions regarding this statement, please ask before signing.

Vestavia Country Club is an Equal Opportunity Employer. No question on this application is asked for the purpose of limiting or excluding any applicant from consideration of employment because of his or her race, color, religion, sex, national origin, physical disability, mental disability, age or veteran status.

I understand that this application is not an offer of employment and that by accepting my application, Vestavia Country Club does not guarantee that I will be offered a job. I also understand that Vestavia Country Club reserves and retains the right to make such changes in the terms and conditions of any employment relationship, with or without notice, as Vestavia Country Club determines to be necessary or appropriate.

I understand that no employment relationship with Vestavia Country Club is for any guaranteed length of time, that employment is based on the consent of both Vestavia Country Club and the individual employee, and that both Vestavia Country Club and its employees have the freedom to terminate the employment relationship whenever either chooses to do so. I also understand that no policy, procedure or practice of Vestavia Country Club may in any way constitute or be construed as either a contract of employment between Vestavia Country Club and any employee or a promise of employment. I understand that no one other than the Chief Operating Officer of Vestavia Country Club has authority to make any other agreement and any such agreement by the Chief Operating Officer must be in writing.

I understand that any offer of employment may be conditioned on the successful completion of a test for drug/alcohol abuse. If offered a job, I agree to submit to such drug/alcohol test and/or physical examinations and to have the results released to appropriate company officials.

I understand and agree that employment with Vestavia Country Club is contingent upon the successful completion of a drug screening test and that successful completion of the test is not guarantee of employment or job availability.

The Immigration Reform and Control Act of 1986 require employers verify the legal work authorization and identity of all new employees. An offer of employment will depend upon Vestavia Country Club’s ability to verify this necessary information.

Failure to sign an authorization and release for employment verification or any other document required by Vestavia Country Club may be deemed a withdrawal of my application for employment.

I certify that all statements made by me on this application as well as in employment interviews are true and complete to the best of my knowledge and that I have withheld nothing. Moreover, I understand that any omission or misrepresentation of fact may result in refusal of employment or immediate dismissal if and whenever discovered.

Signature :
Date :
Signature :
Date :


A parent or legal guardian signature is required If applicant is under the age of 18 years.

Authorization to release employment reference informationCollapse

I hereby (a) authorize inquiries seeking information and/or verification concerning my personal and employment history, and (b) release from all liability, damage and/or responsibility all persons, schools, corporations, governmental agencies or other organizations furnishing information and/or documents, regarding my personal or employment history, and (c) authorize the release of any such information and/or documents, including law enforcement records.

Signature :
Date :