THE RAVEN GOLF CLUB AT VERRADO
4242 N. Golf Drive
Buckeye, AZ 85396
(623) 388-3000

Full Name**: Best Phone To Reach You**: Email**:

Street Address**:

City, State, Zip**:

Are you 18 or older?** YesNo

Are you a citizen of the U.S. or do you have the legal right to be employed in the U.S.?** YesNo

If hired, you will be required to furnish documents prior to commencement of employment to verify your identity and employment eligibility, as required by U.S. Immigration and Naturalization.

Have you ever been convicted of a felony, including DWI/DUI?** YesNo

If yes, state offense, location, date, and disposition

NOTE: A conviction will not necessarily disqualify you from employment.

Do you have any obligations or conditions, which would limit your ability to travel? YesNo

Do you have any obligations or conditions, which would limit your ability to work overtime? YesNo

Driver's License No.: Type: State:

Is the license currently valid? YesNo

List names of employers in consecutive order with present or last employer listed first. Account for all periods of time including military service and any periods of unemployment. If self-employed, give firm name and supply business references on a separate sheet of paper. Please complete even if you are including a resume.

Have you ever been discharged by an employer? YesNo

If yes, please explain all terminations:

• • Employer:
    
  • Dates Employed:
    
  • Starting Wage/Salary:
    
  • Describe the work you did, and please include skills you could apply to Raven.
    
• • Position/Title:
    
  • Supervisor's Name/Title:
    
  • Final Wage/Salary:
    
• • City/State:
  • Phone Number:

  • May we contact this employer? YesNo

  • If not, why not?
  • Reason for leaving?

• • Employer:
    
  • Dates Employed:
    
  • Starting Wage/Salary:
    
  • Describe the work you did, and please include skills you could apply to Raven.
    
• • Position/Title:
    
  • Supervisor's Name/Title:
    
  • Final Wage/Salary:
    
• • City/State:
  • Phone Number:

  • May we contact this employer? YesNo

  • If not, why not?
  • Reason for leaving?

• • Employer:
    
  • Dates Employed:
    
  • Starting Wage/Salary:
    
  • Describe the work you did, and please include skills you could apply to Raven.
    
• • Position/Title:
    
  • Supervisor's Name/Title:
    
  • Final Wage/Salary:
    
• • City/State:
  • Phone Number:

  • May we contact this employer? YesNo

  • If not, why not?
  • Reason for leaving?

Upload Your Resume (Optional):

Are you seeking**: Full TimePart Time

Position applied for**: Desired Salary**:

Date available to start work**:

Are you now or do you expect to be engaged in any other business or employment? YesNo

Are there any days or hours you would be unable or unwilling to work? YesNo

Please specify those days or hours you would be available to work**

• High School Name, City, State:
  

  Years Completed: 1234

  Graduated: YesNo

• College/Trade Name, City, State
  

  Years Completed: 1234

  Graduated: YesNo

  Degree Earned:
• Other School Name, City, State:
  

  Years Completed: 1234

  Graduated: YesNo

  Degree Earned:

Are you planning to pursue further studies? YesNo

If so, when, where and what courses?

List any scholastic honors, offices held and special activities during high school and college:

List and describe any other education or specialized training:

Have you ever served in the military? YesNo

Service Branch: Date Entered:

Final Rank: Date Separated:

Are you a member of a reserve organization? YesNo

Operate power tools? YesNo Operate Machinery? YesNo

Please list any special training you have:

Certificates:

Please use the space below to describe why you are interested in working for the Company and list those skills and abilities, which you feel particularly qualify you for a position with us.

You may be required to pass a physical exam and drug screen as a condition of employment with the Company.

Are you able to perform the essential functions of the job you are applying for with or without reasonable accommodations?
YesNo

How did you hear about the Company's employment opportunities?**

Newspaper Job Fair Friend Current Raven Employee (name optional): Other:

Give three references who are not relatives or former employers.

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed by the Company, any false, misleading or otherwise incorrect statement made on this application form during any interviews may be grounds for my immediate discharge.

I hereby authorize the Company to contact any company or individual it deems appropriate to investigate my employment history, character and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of such investigation, In addition, I hereby waive my right to bring any cause of action against these individuals for defamation, invasion of privacy or for any reason, because of their statements.

I agree that if I am employed by the Company, I will abide by all of the rules and regulations of the Company, also understanding that the taking of drug tests as a condition of continued employment and refusal to take such tests when asked will be grounds for my immediate termination.

I further understand that nobody in the Company is authorized to enter into any written or verbal employment contracts with me for any definite period of time without the express written consent of Company management. I also understand that if I am employed by the Company, such employment is "at-will" and may be terminated by myself or by the Company at any time for any reason or no reason at all, with or without prior notice.

Were you referred by a current Raven employee?** YesNo   If yes, who? (optional)

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  Electronic Signature
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