Xtreme Altitude Gymnastics Employment Application This form must be filled out in its entirety and submitted with THREE references in order to be considered for a job at Xtreme Altitude Gymnastics. If a field does not apply to you, please put N/A.Personal InformationEmail* Date*Name (Last, First)*Street Address*City, State, Zip Code*Cell Phone # (or home # if you don't have a cell phone)*How did you hear about us?*Job InformationPosition(s) applying for (check all that apply)* Preschool gymnastics instructor School age gymnastics instructor Birthday parties/special events Front Desk Team coach (must have prior competitive coaching experience)Expected pay rate?*Days and times you are available to work?*(Mornings -- 9am-Noon, Afternoons -- 2pm-5pm, Evenings -- 6pm-9pm) Monday mornings Monday afternoons Monday evenings Tuesday mornings Tuesday afternoons Tuesday evenings Wednesday mornings Wednesday afternoons Wednesday evenings Thursday mornings Thursday afternoons Thursday evenings Friday mornings Friday afternoons Friday evenings Saturdays SundaysWhat date can you begin working?*Are you 16 years or older?* Yes No (if no, you may need to obtain a work permit)If under 18, please enter your date of birth*If over 18, please put N/AAre you currently employed?* Yes NoAre you prevented from becoming lawfully employed due to Visa or immigration status?* Yes NoHave you ever been convicted of a felony? Yes NoHave you ever been convicted of any crime, including sex-related or child abuse related claims? Yes NoDo you have your own car or a dependable way to work? Yes NoEducationName and location of high school (if not applicable, put N/A)*Number of years completed* 0 1 2 3 4Did you graduate?* Yes NoName and location of college (if not applicable, put N/A)*Number of years completed* 0 1 2 3 4 5 or moreDid you graduate?* Yes NoDescribe any special honors, awards, specialized training or certifications (if none, put N/A)*Employment Experience(please start with your present or most recent job)How many previous jobs have you had? (select up to 4)*01234Company Name (1)*Name and phone number of immediate supervisor (1)*Date started (1)*Date ended (if applicable) (1)*Please select one of the following (1) I am no longer employed at this company and it is OK to contact my former supervisor I am no longer employed at this company and it is NOT OK to contact my former supervisor I am still employed at this company and it is OK to contact my supervisor I am still employed at this company and it is NOT OK to contact my supervisorStarting/Ending payrate? (1)*Duties and responsibilites (1)*Reason for leaving? (if applicable) (1)*Company Name (2)*Name and phone number of immediate supervisor (2)*Date started (2)*Date ended (if applicable) (2)*Please select one of the following (2)* I am no longer employed at this company and it is OK to contact my former supervisor I am no longer employed at this company and it is NOT OK to contact my former supervisor I am still employed at this company and it is OK to contact my supervisor I am still employed at this company and it is NOT OK to contact my supervisorStarting/Ending payrate? (2)*Duties and responsibilites (2)*Reason for leaving (if applicable) (2)*Company Name (3)*Name and phone number of immediate supervisor (3)Date started? (3)*Date ended (if applicable) (3)*Please select one of the following (3)* I am no longer employed at this company and it is OK to contact my former supervisor I am no longer employed at this company and it is NOT OK to contact my former supervisor I am still employed at this company and it is OK to contact my supervisor I am still employed at this company and it is NOT OK to contact my supervisorStarting/Ending payrate? (3)*Duties and responsibilites (3)*Reason for leaving (if applicable) (3)*Company Name (4)*Name and phone number of immediate supervisor (4)Date started (4)*Date ended (if applicable) (4)*Please select one of the following (4)* I am no longer employed at this company and it is OK to contact my former supervisor I am no longer employed at this company and it is NOT OK to contact my former supervisor I am still employed at this company and it is OK to contact my supervisor I am still employed at this company and it is NOT OK to contact my supervisorStarting/Ending payrate? (4)*Duties and responsibilites (4)*Reason for leaving (if applicable) (4)*Personal QualitiesDescribe the qualities you have that would make you a great addition to our team*Understanding and agreementPlease initial or type your name as indicated below each statement.I certify that the statements given on this application or during an interview are true and complete and I authorize investigation of same with exception of contacting my current employer if I have so requested in this document. I have read and agree to the above statement (initial in the box below)*I understand that if I am hired that any false, incomplete or misleading information given herein or during an interview shall result in immediate termination. I have read and agree to the above statement (initial in the box below)*Electronic signature (type your full legal name in the box below)*Xtreme Altitude Gymnsatics is an EQUAL OPPORTUNITY EMPLOYER and does not discriminate against applicants or employees on the basis of race, color, gender, marital status, religion, national origin, age, veteran status, disability or any other basis prohibited by local, state or federal law. No question on this application is intended for or will be used for the purpose of limiting or excusing any applicant's consideration for employment.ReferencesPlease submit three references, TWO of which must be professional.I hereby authorize all references listed below to provide a full and honest assessment of my character to Xtreme Altitude Gymnastics (please type your name below)*Reference #1 - Name, phone number and your relationship to the reference*Reference #2 - Name, phone number and your relationship to the reference*Reference #3 - Name, phone number and your relationship to the reference*
