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.?

Which are you applying for?

If Summer please provide last day available to work.

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