Application

APPLICATION FOR EMPLOYMENT

Notice to applicant. We are an equal opportunity employer and do not discriminate on the basis of an
applicant's or employees race, color, religion, sex, sexual preference, national origin, citizenship, age,
physical or mental disability or any other characteristics.

PERSONAL INFORMATION

POSITION INFORMATION

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EDUCATIONAL INFORMATION

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REFERENCES

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EMPLOYMENT HISTORY

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EMERGENCY CONTACT INFORMATION: (In case of emergency, who should we call?)

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ACKNOWLEDGEMENT (Please read carefully):

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I hereby certify that the information contained in this application form and any attachments is true and correct to the best of my knowledge and agree to have any statements checked by Rollingwood Athletic Club, unless I have indicated contrary. I authorize the reference listed to provide Rollingwood Athletic Club any and all information concerning my previous employment and any pertinent information that they may have. Further, I release all parties and persons from any liability for any damages that may result from furnishing such information to RAC as well as the use or disclosure of such information by organizations or any of its agents, employees, or representatives. I understand that any misrepresentation on this application may result in my immediate termination if I am hired.

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