First Name *

Last Name *

Street Address *

City *

State *

Cell Phone *

Email *

Date Available to Start *

Position(s) Applying for

Provide Hours Available to Work for each day of the week Monday through Sunday

Are you a citizen of the United States? *

If you are not a citizen, are you authorized to work in the U.S.?

Have you previously been employed by Worthington Manor Golf Club? *

If yes,when?

Do you have a valid driver’s license? *

Have you ever been convicted of a felony? *

If you been convicted of a felony, please explain

Provide Education Background (Diploma/Degree) & Trade Skills

Professional Reference #1 - please provide Name, Relationship, Company & Phone Number

Professional Reference #2 - please provide Name, Relationship, Company & Phone Number

List Current or Previous Employment #1 - Company, Phone Number, Supervisor, Job Title, Start & End Date

For employment #1 may we contact current or previous supervisor for reference?

List Current or Previous Employment #2 - Company, Phone Number, Supervisor, Job Title, Start & End Date

For employment #2 may we contact current or previous supervisor for reference?

Please list additional skills or information you'd like to provide