Employment Application

Applicant Data

Programs, Services, and Employment are equally available to everyone. We are an Equal Opportunity Employer.

First Name

Middle Name

Last Name

Date of Birth

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone Number

Desired Start Date

Salary Requirements

Are you legally allowed to work in the United States?

Yes

If you are under the age of 18, can you provide a work permit?

Yes

Not Applicable

If no, please explain.

Type of Employment Desired

Part Time General Help / Front Counter

Part Time Coach / Lessons

Lil' Kickers Coach

Certified Personal / Team Gym Trainer

Camp / Clinic / PDP Coach / Helper

Full Time (40 hours)

Have you ever pleaded guilty, no contest or been convicted of a crime?

Yes

If yes, please explain.

Answering yes to these questions does not constitute an automatic rejection for employment. Date of offense, seriousness, and nature of the violation, rehabilitation, and position applied for will be considered. Answering yes to these questions does not constitute an automatic rejection for employment. Date of offense, seriousness, and nature of the violation, rehabilitation, and position applied for will be considered.

Do you have a Drivers License?

Yes

Are you willing to take a Drug Test?

Yes

Are you willing to allow a background check?

Yes

Do you have any experience in coaching, teaching, or working with Children, Young Athletes, Teen Athletes, or High School Athletes?

Yes

If yes, please explain.

Do you enjoy working with Children, Young Athletes, Teen Athletes, and High School Athletes?

Yes

Education History

Name of High School

Name of College (if applicable)

College Graduation Year (if applicable)

Summarize Your Special Skills or Qualifications

What sports have you played?

What sports are you currently playing?

Employment History

Begin with most recent position.

Current Employment Status

This would be my first job

I am currently employed, see history below

I am currently unemployed, see history below

Employer Name #1

Dates Employed

Position Held

Supervisor

Phone

May we contact this employer for a reference?

Yes

Reason for Leaving

Employer Name #2

Dates Employed

Position Held

Supervisor

Phone

May we contact this employer for a reference?

Yes

Reason for Leaving

References

Reference #1

Phone

Reference #2

Phone

Reference #3

Phone

Acknowledgement

I certify that the facts contained in the application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements herein and the references and employers listed above to give you any and all information concerning my previous employment and my pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is written and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.

I also agree to abide by any company regulations concerning COVID - 19.

I certify...

Yes

Digital Signature

Date Signed

Human Verification: Please check all numbers below.

ABC