The X Gentleman Club

APPLICATION FOR EMPLOYMENT

We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, martial or veteran status, the presence of a non job related medical condition or handicap, or any other legally protected status. Proof of citizenship or immigration status will be requested upon employment

Date of Application

Last Name	First Name	Middle Name or Initial

Address	City	State	Zip Code

Telephone Number's	Social Security Number
(Work) (Home)

Date Available

Are you available :

Full Time

Part Time

Weekends

Have you been convicted of a felony within the past 7 years?	Yes	No
Conviction will not necessarily disqualify an applicant from employment.
If Yes, attach explanation.

Education
High School	Undergraduate	Graduate

School Name & Locations
Years Completed
Diploma/Degree
Course of Study
State any additional information you feel may be helpful to us in considering your application (such as any specialized training; skills; apprenticeships; honors received; professional, trade, business, or civic organizations or activities; job-related military training or experience; foreign language abilities; etc.)

Employment History (Last Employer First)

Date

From	To

Employers Name and Address

Name	Address

Kind of Work

Salary

$	Per

Reason for Leaving

Additional Rmarks

Do you have the legal right to reside and work in the United States?

Yes

Proof of citizenship or immigration status may be required upon employment

Applicant's Statement

I certify that the information given on this application is true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application, and understand that false or misleading information given in my application or interview(s) may result in discharge. I understand and acknowledge that, unless otherwisde defined by applicable law, any employment relationship with this organization is "at will", which means that I may resign at any time and the employer may discharge me at any time with or without cause. I further understand that this "at will" employment relationship may not be changed orally, by any written document, or by conduct, unless such change is specifically acknowledged in writing by an authorized executive of the organization.

APPLICATION FOR EMPLOYMENT