PERSONAL INFORMATION
 

DATE OF BIRTH:

EMAIL:

TODAY'S DATE:

 

NAME:

SOCIAL SECURITY NUMBER:

LAST

FIRST

MIDDLE

 

ADDRESS:

STREET

CITY

ZIP

STATE

 

PHONE NUMBER:

EMERGENCY PHONE:

 

IN CASE OF EMERGENCY, NOTIFY:

NAME

ADDRESS

PHONE NUMBER

 

ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE UNITED STATES? YesNo

(Proof will be required upon hire.)

 

HAVE YOU EVER BEEN CONVICTED OF A CRIME, INCLUDING A MISDEMANOR OR FELONY? YesNo

(Do not include any convictions that have been sealed or expunged.)

DESCRIBE ANY AND ALL CONVICTIONS IN ANY STATE: *You not be denied employment soley because of a conviction record, unless the offense is related to the job for which you've applied.   DO YOU SPEAK ANOTHER LANGUAGE? Yes No   IF SO, WHAT LANGUAGE(S)?

 

How were you referred for employement with Kingdom Sports?  Ad  Friend  Relative  Employee

IF SO, WHO?

 

EMPLOYMENT DESIRED
 

POSITION:

DATE YOU CAN START:

 

ARE YOU EMPLOYED NOW? Yes  No

IF SO, WHERE?

 

EVER APPLIED TO THIS COMPANY BEFORE?  Yes  No

IF SO, WHEN AND FOR WHAT POSITION?

 

EVER WORKED FOR THIS COMPANY BEFORE? Yes  No

IF SO, WHEN AND FOR WHAT POSITION?

 

EDUCATION
 

EDUCATION	NAME AND LOCATION	NO. OF YEARS ATTENDED	DID YOU GRADUATE	SUBJECTS STUDIED
HIGH SCHOOL
COLLEGE/UNIVERSITY
TRADE, BUSINESS, CORRESPONDENCE, OR GRADUATE SCHOOL

 

FORMER EMPLOYERS (List below your last four employers starting with last one first)
 

DATE MONTH & YEAR	NAME, ADDRESS, & PHONE NUMBER  OF EMPLOYER	SUPERVISOR	SALARY	POSITION	REASON FOR LEAVING
FROM: TO:
FROM: TO:
FROM: TO:
FROM: TO:

 

EXPERIENCE
 

LIST ANY COACHING/OFFICIATING EXPERIENCE INCLUDING LEVEL	LIST OTHER RELATED EXPERIENCE THAT MIGHT PROVE HELPFUL IN OUR COMPANY. INCLUDE EXPERIENCE WORKING WITH CHILDREN, IN FIELD OF SPORTS, WEB DESIGN, TECHNOLOGY, MARKETING, ETC...

 

REFERENCES (Give the names of three persons not related to you, whom you have known at least one year)
 

NAME	ADDRESS AND PHONE NUMBER	BUSINESS	YEARS ACQUAINTED
1.
2.
3.

AGREEMENT

Are you capable of performing with or without reasonable accommodation the essential functions of the job or occupation for which you have applied? (Do not answer this question unless you have been informed about the requirements of the job or occupation for which you are applying, or have received a copy of the job description.)  Yes  No

I certify that I do not have a written agreement with a former or present employer that would conflict with or in any way prevent me from working for Kingdom Sports to which I am applying.

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, no matter when discovered.

I authorize investigation of all statements contained herein and consent to CEI contacting employers and references or others who would have knowledge of my qualifications for the job. I authorize employers and references listed above to give CEI any and all information concerning 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 CEI.

I understand that this application is not a contract of employment or of any other kind and that my employment is at will and may be terminated by either party at any time and for any reason or for no reason, with or without notice. Any employment agreement must be in writing and executed by the president of CEI.

I consent to giving specimens to test for the possible presence of illegal drugs, and misuse of legal drugs. I also consent to CEI sending the speciemens to a laboratory for testing and maintaining the result of the tests among its records. I undestand that if the tests indicate the possible presence of drugs, and misuse of legal drugs, CEI may revoke an offer of employment and not hire me.

In exchange for considering me for possible employment and/or as a term and condition of my employment, I release, and covenant not to sue CEI, its affiliates, successors, assigns, employees, agents, officers, directors, stockholders, owners, or authorized representatives (CEI) from any claim that I may have relating to the matters for which I have given my consent.

I may be offered employment conditional on my passing a medical examination (to the extent permitted by law including both drug and alcohol test), and I consent to take such examinations. If I am employed by CEI and, during my employment, CEI requires that I undergo a medical examination (to the extent permitted by law, including both drug and alcohol test), I hereby consent to such examinations. I also agree and consent to take any intelligence or personal profile required by CEI at any time.

I hereby agree that the all information contained within this document to be true to the best of my ability and understanding. If hired, I will abide by all company work rules, polices, and procedures relating to work performance and conduct.  I Agree  I Don't Agree

Please list date of completion below (MM/DD/YYYY).