WOODY’S GOLF RANGE

Required fields marked with a *

General Information

*Legal First Name

M.I.

*Legal Last Name

*At least one phone number required:

Home Phone: ( ) --

Work Phone ( ) --

Cell Phone ( ) --

* E-mail:

* Address:

Address 2:

* City

* State:

* Zip code:

Questionnaire

1. Are you 16 years of age or older? *

Yes No

2. Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.? *

Yes No

3. If offered a position, would you be willing to submit to a background check and drug test? *

Yes No

4. Would you be comfortable asking a customer to sign up for one of our membership programs?

Yes No

5. How much experience do you have with cash handling and/or operating a cash register? *

None

Less than 6 months

6 months to 1 year

2 or more years

6. Are you available to work a flexible schedule including nights, weekends and holidays? *

Yes No

Hours Available

• Please indicate the hours you are available to work. Hours of operation will vary.

Times available range from 6 am to 11 pm.

From would be your start time i.e. 8 am. To would be end time i.e. 4 pm

If you are available any time just enter any in the From and To lines for that day

Mon Tue Wed Thu Fri Sat Sun

Day

From

To

Employment Interests

Approximate Date Available for Employment: (MM/DD/YYYY

It is Woody’s policy not to employ people that are related, through blood, marriage, or adoption

if there will be a direct reporting relationship between the associates and would place the individual

in a position of exercising supervisory, appointment or grievance adjustment authority over a

member of the individual’s family exercises.

Would your employment violate this policy?

Yes No

Have you previously applied, interviewed, or been employed by Woody’s Golf Range?

Yes No

If “yes”, please list the dates of your previous employment with us:

Approximate salary requirements:

$ per hour

Education

No Education History

High School City / State

# of Years Completed Degree Certificate

College or University City / State Major

# of years Completed Degree / Certificate

Other City / State Major

# of years completed Degree / Certificate

Employment History

Give complete information regarding present and former employment. Please provide information on

your 3 most recent jobs. If you do not have 3, mark the last history as your final employment history,

but do not omit any jobs that fall within the last three. Start with your present/last job. You may include

as a part of your employment history any verified work performed on a volunteer basis.

No Employment History

May we contact this employer?

Yes No

Current employer Yes No

Name of company Phone

Address: Dates of employment: (mm/dd/yyyy)

Job Title / Duties: Supervisor Name / Title

Starting Salary Ending Salary

per hour per hour

Reason for leaving, be specific and note if involuntary:

May we contact this employer?

Yes No

Current employer Yes No

Name of company Phone

Address: Dates of employment: (mm/dd/yyyy)

Job Title / Duties: Supervisor Name / Title

Starting Salary Ending Salary

per hour per hour

Reason for leaving, be specific and note if involuntary:

May we contact this employer?

Yes No

Current employer Yes No

Name of company Phone

Address: Dates of employment: (mm/dd/yyyy)

Job Title / Duties: Supervisor Name / Title

Starting Salary Ending Salary

per hour per hour

Reason for leaving, be specific and note if involuntary:

Addition Data

Are you currently a party to any agreement with your current or former employer that

Contains post-employment restrictions that may impact your ability to work here?

Yes No

Are you able, at the time of employment, to submit verification of your legal right to work in the U.S.?

Yes No

Are you 16 years of age or older?

Yes No

Have you been convicted of a felony or misdemeanor within the past seven years that has not been

expunged, sealed, pardoned, annulled, statutorily eradicated or dismissed upon condition of probation?

(A conviction record will not necessarily be a bar to employment and will not necessarily disqualify

an applicant from consideration. A conviction which is substantially related to the functions or

qualifications of the position(s) for which you are applying may be taken into consideration.)

Yes No

If YES, please describe the date of the conviction, the nature of the offense and your subsequent rehabilitation:

References

Please provide work-related references whom we may contact. Please exclude supervisos listed above.

School or volunteer related references may be listed.

Name Phone #

Years Known Relationship

Name Phone #

Years Known Relationship

Name Phone #

Years Known Relationship

Applicant Statement

My signature below indicates that I have made true, correct, and complete answers and statements

on this application with the knowledge that the company will rely upon the information I provided

when considering my application for employment. I understand that any omission or false

statement made by me on this application will constitute sufficient grounds to reject my application

or terminate my employment. If the company does hire me, I agree to conform to the Company’s

rules and policies, and I understand that I will be an employee at-will, which means that I can voluntarily

end my employment or be terminated at any time without cause or notice. No statement, whether written

or oral, by any company representative other than a written statement signed by the president and myself

may vary the foregoing.

Type your name Date:

By entering your full name in the box above, this will represent your electronic signature which you agree

Woody's Golf Range can rely upon to the same extent as your handwritten signature.