BASELINE TENNIS Employment Application

Applicant Information – ATTACH RESUME IF APPLICABLE

Last Name

First

M.I.

Street Address

Apartment/Unit #

City

State

ZIP

Phone

E-mail Address

Date Available

Social Security No.

Desired Salary

Position Applied for

Are you a citizen of the United States?

YES

NO

If no, are you authorized to work in the U.S.?

YES

NO

Have you ever worked for this company?

YES

NO

If so, when?

Have you ever been convicted of a felony?

YES

NO

If yes, explain

Education

High School

Address

From

To

Did you graduate?

YES

NO

Degree

College

Address

From

To

Did you graduate?

YES

NO

Degree

Are you certified by any trade organizations; USPTA, PTR, ECT. ?

YES

NO

If so, which?

What year did you obtain your certification?

Are your certification dues current?

If not, last year current?

References

Please list three references.

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

Previous Employment
Company					Phone
Address					Supervisor
Job Title			Starting Salary		$	Ending Salary	$
Responsibilities
From	To	Reason for Leaving
May we contact your previous supervisor for a reference?				YES	NO
Company					Phone
Address					Supervisor
Job Title			Starting Salary		$	Ending Salary	$
Responsibilities
From	To	Reason for Leaving
May we contact your previous supervisor for a reference?				YES	NO
Company					Phone
Address					Supervisor
Job Title			Starting Salary		$	Ending Salary	$
Responsibilities
From	To	Reason for Leaving
May we contact your previous supervisor for a reference?				YES	NO
BASELINE FACILITY LOCATION(S) THAT YOU ARE APPLYING FOR
Facility
Full-Time