Application for Employment
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1 Application for Employment
2 WILLOW OAKS COUNTRY CLUB APPLICATION FOR EMPLOYMENT (Confidential) PLEASE PRINT Qualified applicants are considered for all positions without regard to race, color, religion, creed, marital status, disability, sexual orientation, citizenship status, sex, national origin, age, handicap or veteran status, or any other status protected by applicable law. Name Address LAST FIRST MIDDLE NUMBER STREET CITY STATE ZIP Date How Long There? Phone No. Social Security No. AREA CODE Previous Address NUMBER STREET CITY STATE ZIP How Long There? Thank you for considering Willow Oaks Country Club as an employer. ensure that we make a hiring decision that is right for you, and us we use a number of different selection tools and consider a great amount of information before a decision is made. As you go through the employee selection process, you may come in contact with some or all of the following selection tools. 1. Emplovment Application - Complete all sections which pertain to you. Do not include a resume as a substitute for incomplete information. Sign and date the application. The employment application allows Willow Oaks Country Club to determine your qualifications and experience. by signing the application, you authorize Willow Oaks Country Club to verify the information contained in the application. Falsification of information on the application of failure to provide accurate information can result in disqualification for employment or termination of employment if discovered after hire. 2. Dispute Resolution Agreement - This agreement requires you to first attempt to resolve any legal dispute related to your application for employment or employment with Willow Oaks Country Club through mediation (not arbitration). Willow Oaks Country Club will not consider your application unless this agreement is signed. 3. Emplovment Interviews - Several personal (or telephone) interviews may be conducted with you in order to provide more detailed information regarding your background and qualifications. 4. Reference Checking - Former employers and educational references may be verified prior to an offer of employment. 5. Employment Evaluation - Various tests may be administered to measure your aptitude and abilities in job related areas. 6. Screenings - You will be required to undergo a pre-employment drug screen, security background and credit check prior to employment. 7. Emplovment Eligibilitv Verification - This form is required by the U.S. Department of Justice and the Immigration and Naturalization service. It is used to verify your identity and right to work in the United States.
3 DISPUTE RESOLUTION AGREEMENT I recognize that differences possibly may arise between Willow Oaks Country Club and me during my application or employment with Willow Oaks Country Club. I recognize that it is in the interest of both Willow Oaks Country Club and me that all disputes be resolved in a manner that is private, expeditious, economical, and less burdensome or adversarial than court litigation. Willow Oaks Country Club has an effective Open Door Policy, and I will try to take advantage of it where feasible. I understand, however, that not all issues can be resolved using the Open Door Policy. I agree that I will first attempt to settle any and all previously unasserted claims, disputes, or controversies arising out of or relating to my application or candidacy for employment, employment and/orcessation of employment with Willow Oaks Country Club, by mediation before a neutral mediator. By way of example only, such claims include claims under federal, state and local statutory or common law, such as the Age Discrimination in Employment Act, Title VII of the Civil Rights Act of 1964, as amended, including the amendments of the Civil Rights Act of 1991 and the Americans with Disabilities Act. I understand that if I do file a lawsuit regarding a dispute arising out of or relating to my application or candidacy for employment, or cessation of employment. Willow Oaks Country Club may use this Agreement in support of its request to the court to dismiss the lawsuit or first attempt to resolve the dispute through mediation. I understand that I still may file administrative charges with the Equal Employment Opportunity Commission or similar federal, state or local agency, but that upon receipt of a right-to-sue letter or similar administrative determination, I will first attempt to resolve any claim that I may have against Willow Oaks Country Club through mediation. I understand that I must submit a request for mediation within 180 days of the day on which I learned or. through reasonable diligence, should have learned that my legal rights were violated. I further agree that if I commence with mediation it will be conducted in accordance with the Willow Oaks Country Club Dispute Resolution Procedures. I understand that neither this Agreement nor the Dispute Resolution Procedures form a contract of employment between Willow Oaks Country Club and me. I further understand that my signature to this Agreement in no way guarantees that Willow Oaks Country Club will accept may application for employment. If Willow Oaks Country Club does accept my application for employment and Ibecome employed by Willow Oaks Country Club, this Agreement in no way alters the "at-will" status of my employment. I understand that my employment, compensation, and terms and conditions of employment can be altered or terminated, with or without cause, and with or without notice, at any time, at the option of either Willow Oaks Country Club or myself. I understand that only the Club executive has the authority to enter into any agreement for employment for any specific duration or to make any agreement contrary to the foregoing. Page 2
4 The Dispute Resolution Agreement and the Dispute Resolution Procedures may affect your legal rights. You may wish to seek legal advice before signing this Dispute Resolution Agreement. I have read this Agreement and understand that I should read the Dispute Resolution Procedures over the next few days. I understand that I may withdraw my consent to this Agreement within three days from the date on which I sign below by notifying the Human Resource Department in writing (including my Social Security number) that I am withdrawing my application for employment at Willow Oaks Country Club. The address for the Human Resource Department is: Willow Oaks Country Club 6228 Forest Hill Ave. Richmond, VA I understand that by so notifying the Human Resource Department, I will not be bound to this Agreement and that I no longer will be eligible for employment at Willow Oaks Country Club. I recognize that if I sign the Agreement and do not withdraw within three days of signing 1 will be required to first attempt to resolve any and all employment-related claims I may have against Willow Oaks Country Club, whether or not I become employed by Willow Oaks Country Club through mediation. This Agreement will be enforceable throughout the application process, my employment, and thereafter with respect to any claims arising from or relating to my application or candidacy for employment, or cessation of employment with Willow Oaks Country Club. AGREED: Signature Date Social Security No. Willow Oaks Country Club agrees to follow this Dispute Resolution Agreement and the Dispute Resolution Procedures in connection with the Associate whose signature appears above.
5 STOP! IF YOU HAVE NOT SIGNED THE AGREEMENT... If you have decided not to agree to the terms of the preceding DISPUTE RESOLUTION AGREEMENT then you do not need to complete the balance of this application. We appreciate your interest in the Club. IF YOU HAVE SIGNED THE AGREEMENT... If you have decided at this time to agree to the terms of the preceding DISPUTE RESOLUTION AGREEMENT then you will need to complete the balance of this application so that we can continue with your application process. Rate of Pay Desired Position Desired Have you filed an application here before? Yes No Date Have you ever been employed here before? Yes No Date State age if under 18 Are you legally eligible for employment in the U.S.A.? Yes No Can you, if hired, provide proof of your legal right to work in the U.S.A.? Are you available to work? Full Time Part Time Are you on lay-off and subject to recall? Yes No Yes No Seasonal Have you been convicted of any criminal offenses in the past 10 years? Yes No If yes, describe in full A conviction of a criminal offense may be relevant if job related, but will not automatically bar you from consideration for employment. Who referred you to this Club? (please check) Newspaper Ad State Employment Agency Club Employee Employment Agency NAME NAME Friend NAME Walked In Other NAME RECORD OF EDUCATION SCHOOL NAME AND LOCATION OF SCHOOL COURSE OF STUDY NO. OF YEARS COM- PLETED DID YOU GRADUATE? DEGREE OR DIPLOMA GPA HIGH SCHOOL YES NO COLLEGE/ UNIV. YES NO COLLEGE/ UNIV. YES NO BUSINESS/ TECH.VOC. YES NO Page 4
6 EMPLOYMENT HISTORY DO NOT SUBSTITUTE RESUME START WITH PRESENT OR MOST RECENT EMPLOYER Please give accurate, complete full-time and part-time employment record. Explain any lapse of time. Address (Street) (City) (State) (Zip) 1 Name of Supervisor Supervisor s Title State Job Title and Describe Your Work Reason for Leaving Address (Street) (City) (State) (Zip) 2 Name of Supervisor Supervisors Title State Job Title and Describe Your Work Reason for Leaving Addras (Street) (City) (State) (Zip) 3 Name of Svpervisor Supervisor's Title State Job Title and Dercribe Your Work Reason for Leaving Address (Street) (City) (State) (Zip) 4 Name of Supervisor Supervisor s Title State Job Title and Describe Your Work Reason for Leaving 5 Addras (Street) (City) (State) (Zip) Name of Supervisor Supervisor s Title State Job Title and Describe Your Work Reason for Leavtng DO NOT CONTACT We may contact the employers listed above unless you indicate those you do not want us to contact. Number(s) Reason Page 5
7 SPECIAL SKILLS -- WORD PROCESSOR/COMPUTER TYPING wpm FAX CALCULATOR OTHER STATE ANY ADDITIONAL INFORMATION YOU FEEL MAY BE HELPFUL TO US IN CONSIDERING YOUR APPLICATION. OTHER: MILITARY SERVICE RECORD BRANCH OF SERVICE RANK AT DISCHARGE DATES OF SERVICE PRESENT MEMBERSHIP IN NATIONAL GUARD OR RESERVES DATE OBLIGATION ENDS NOTICE TO APPLICANTS It is the intent of Willow Oaks Country Club to comply with the requirements of the Immigration Reform and Control Act of 1986 and hire only workers who are legally eligible to work in the United States. If you are hired by Willow Oaks Country Club, you will be required to show proof of work eligibility and documentation to establish your true identity. If hired, you must bring these documents with you on your first day of work. AUTHORIZATION I certify that the facts contained in this 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 contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. In consideration of employment, I agree to conform to the rules and regulations of the Club. I understand and agree that, if hired, my employment and compensation can be terminated with or without case and with or without notice at any time. at the will of either the Club or myself. Iagree that I shall remain employed solely on an at-will basis and that this basis may only be altered in writing by the Club executive. DATE SIGNATURE This application will only be considered active for 90 days. If we do not employ you during that period, it will be necessary for you to file a new application with us for further consideration. Page 6
8 6228 Forest Hill Avenue Richmond, Virginia Phone: Revised 1/04
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