Swim Fitness Center LLC

Open Year Round!

350 Sparta Avenue
Sparta, NJ 07871
973-729-3737

Application for Employment
Pre-Employment Questionnaire
Equal Opportunity Employer

Personal Information

Last Name:
First Name:
Social Security Number:
Present Address:
Street:
City:
State:
Zip:
Permanent Address:
Street:
City:
State:
Zip:
Phone Number:
Referred By:

Employment Desired

Position:
Date to Start:
Salary Desired:

Currently Employed:

Yes No

If so, may we enquire of your present employer:

Yes No

Ever applied to this company before:

Yes No

Education

Grammar School:

Name of School:
Location of School:
Years Attended:
Did you graduate:	Yes No
Subjects studied:

High School

Name of School:
Location of School:
Years Attended:
Did you graduate:	Yes No
Subjects studied:

College

Name of School:
Location of School:
Years Attended:
Did you graduate:	Yes No
Subjects studied:

Trade, Business or Correspondence School

Name of School:
Location of School:
Years Attended:
Did you graduate:	Yes No
Subjects studied:

General

Subjects of special study/research work or special training/skills:

U.S. military or naval service:
Rank:

Former Employers

Employer 1
Dates of Employment:	From (MM/YY)	To (MM/YY)
Employer Name:
Employer Address:
Position:
Salary:
Reason for leaving:

Employer 2
Dates of Employment:	From (MM/YY)	To (MM/YY)
Employer Name:
Employer Address:
Position:
Salary:
Reason for leaving:

Employer 3
Dates of Employment:	From (MM/YY)	To (MM/YY)
Employer Name:
Employer Address:
Position:
Salary:
Reason for leaving:

Employer 4
Dates of Employment:	From (MM/YY)	To (MM/YY)
Employer Name:
Employer Address:
Position:
Salary:
Reason for leaving:

References

Name:
Address:
Business:
Years Known:

Name:
Address:
Business:
Years Known:

Name:
Address:
Business:
Years Known:

Authorization

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.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

I Agree I Disagree

Application for Employment Pre-Employment Questionnaire Equal Opportunity Employer

Application for Employment
Pre-Employment Questionnaire
Equal Opportunity Employer