Leisure Time Pool Service & RepairApplication for Employment

Today's Date

Personal Data

Last Name *

First Name *

Present Address *

City

State

Zip *

Home Phone *

Cell Phone

Position Data

Position applied for

Do you have any relatives and/or friends currently working for Leisure Time Pool?

Yes

No

If hired, what date can you start work?

Acceptable Salary Range

Availability

Regular Full Time

Regular Part Time

Temporary Work

From

to

What days and hours are you available for work?

Are you available for overtime or work on weekends?

Yes

No

Are you employed now?

Yes

No

If so, may we contact your present employer?

Yes

No

Applied to Leisure Time Pool before?

Yes

No

When?

Worked for Leisure Time Pool before?

Yes

No

When and Reason for leaving?

Personal Information

If hired, can you present evidence of US citizenship or proof of legal right to live and work in this country?

Yes

No

Are you at least 18 years old? (hire subject to verification of minimum legal age)

Yes

No

Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation?

Yes

No

If no, describe the functions that cannot be performed

** Note we comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination and to skill and agility tests.

Do you have a valid driver's license?

Yes

No

Employment History

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I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. *

I have read and agree

I hereby authorize Leisure Time Pool to thoroughly investigate my references, work record, education, and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notce of such disclosure. In addition, I hereby release Leisure Time Pool, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure. *

I have read and agree

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and Leisure Time Pool. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or Leisure Time Pool, and that no promises or representations contrary to the foregoing are binding on Leisure Time Pool unless made in writing and signed by me and a designated representative of Leisure Time Pool. *

I have read and agree

Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by Leisure Time Pool, I am entitled to copies of such public records obtained by Leisure Time Pool unless I mark the waive of receipt of public record below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the waiver below. *

I have read and agree

I waive receipt of any public record described in the paragraph above. *

I have read and agree

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