EMPLOYMENT APPLICATION
Lexington Country Club is an Equal Opportunity Employer.  All qualified applicants will receive consideration without regard to race, color, religion, sex, age, disability, marital status or national origin.  In accordance with the Americans with Disabilities Act, Lexington Country Club will provide reasonable accomodation upon request to applicants to facilitate the application process.  This is a Drug- and Alcohol-Free Workplace. 
ABOUT YOU
Name
Address
How Long?
City
State
Zip
Home Phone #
Other # where you can be reached
Do you have relatives or friends presently working for Lexington Country Club?
Are you 18 years of age or over?
(If not, employment is subject to verification that you are of legal minimum age and can furnish any required work permit.)
JOB INTEREST
Position(s) Desired
Position(s) Desired
Hours Per Week Desired
Salary Requirements
Date you will be available to begin work
Why do you want this position?
EDUCATION AND TRAINING
Choose Highest Grade Completed
 HIGH SCHOOL
Name
City/State
Did you graduate?
Date
Receive G.E.D.?
Date
 COLLEGE, UNIVERSITY, OR OTHER SCHOOL
Name
City/State
Dates of Attendance
Field of Study
Type of Degree Obtained
Date
Other Education or Training
Name of Facility
City/State
Dates of Attendance
DRIVING RECORD
If you are applying for a position that requires driving a vehicle, please provide the following information:
Driver's License No.
State
Expiration
Has your license ever been revoked or suspended?
If yes, please explain
EMPLOYMENT HISTORY
List all places of employment over the past 10 years, including Military Service.  Please account for all self-employment and gaps in employment.  If you were employed under a different name, please provide that name (please provide in the below).  If you have had more than 3 employers in the past 10 years, please list information below. 
Different Name
Please list any additional employers below.
Present or Last Employer
Supervisor
Mailing Address
City/State/Zip
Phone #
Position Held
Dates of Employment
Salary
per
Duties
Reason for Leaving
May we contact?
Present or Last Employer
Supervisor
Mailing Address
City/State/Zip
Phone #
Position Held
Dates of Employment
Salary
per
Duties
Reason for Leaving
May we contact?
Present or Last Employer
Supervisor
Mailing Address
City/State/Zip
Phone #
Position Held
Dates of Employment
Salary
per
Duties
Reason for Leaving
May we contact?
PERSONAL REFERENCES
Name
Occupation
Years Known
Address
Day Phone
Name
Occupation
Years Known
Address
Day Phone
GENERAL INFORMATION
Do you smoke?
If yes, how much/how often?
BACKGROUND INFORMATION
Are you legally eligible for employment in the U.S.?
(You will be required to provide proof upon employment)
Have you ever committed or been convicted of a crime, entered a plea of nolo contendre (no contest) to a crime or received a suspended sentence (regardless of the ultimate adjudication) for a crime?
If yes please explain
(A criminal record will not necessarily be a bar to employment)
Have you ever been sued for causing the death of, or injury to any person, or any property damage (e.g., for assault, battery, defamation, etc.)?
If Yes: Date:
Please explain the nature of the claims in the lawsuit(s) and disposition(s)
Do you have any commitments, including non-compete agreements or any other restrictive covenants to any other entity, business or person that might affect your employment with Lexington Coutry Club?
If yes please explain
Are there any other experiences, skills or qualifications which you feel especially qualify you for work with Lexington Country Club?
EMERGENCY INFORMATION
Person to be notified in case of emergency:
Name
Telephone
Relationship
Address
APPLICANT'S STATEMENT:

APPLICANT'S STATEMENT:
PLEASE READ THE FOLLOWING CAREFULLY BEFORE ENTERING NAME

I understand that Lexington Country Club will attempt to verify statements made on my application and made during my employment interview.  I give permission for my former employers and personal references, as well as law enforcement officials, to answer any questions and to furnish information concerning me.  I release Lexington Country Club and all former employers and my references from any liability as a result of the furnishing and receiving of this reference and background information.

I understand that false, incomplete or misleading statements or omissions on this application or any other pre- or post-employment documents, or any verbal misrepresentations, may result in disqualification from further employment consideration or termination from employment.

I understand that if I am employed by Lexington Country Club, I must conform to the policies and rules of Lexington Country Club.  I understand that my employment relationship will be at-will and that both Lexington Country Club and I have the right to terminate my employment, with or without cause, and with or without notice.  I understand my job duties and schedule may be changed at any time during my employment by Lexington Country Club.  I understand I may be required to work scheduled and unscheduled overtime and scheduled weekend and holiday work when requested by Lexington Country Club.

I consent and agree to taking any pre-employment physical examinations and such future physical examinations and any drug and alcohol tests as part of or separate from any such physical examinations, as may be required by federal or state law/regulation, as well as Lexington Country Club’s policy.

The Immigration Reform and Control Act of 1986 requires that, after employment, employers verify the legal work authorization and identity of all new employees.  An offer of employment will depend on Lexington Country Club’s ability to verify this necessary information.
Date
Applicant's Name
Thank you for completing this application form and for your interest in employment with us.  Due to the volume of applications received, we may not interview every applicant.  In the event you are selected for interview, we will contact you.  Applications are considered inactive after 30 days from the date of application unless renewed, in writing, by the application at this location. 
INCOMPLETE APPLICATIONS OR APPLICATIONS CONTAINING ADDITIONAL NON-REQUESTED INFORMATOIN WILL NOT BE CONSIDERED.
    
Lexington Country Club
16257 Willowcrest Way
Ft. Myers FL 33908
 Rights Reserved. Privacy Policy (c) 1996-2010
Technical Assistance: ngudith@LexingtonCountryClub.com