Employment Application  
 
EQUAL OPPORTUNITY EMPLOYER
 
Personal Information
Full Name
Street Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
E-mail:
Social Security #
Birth Date*
Date Month Year
Hours
 
Employment Desired
Position Date You Can Start Salary desired Ever Applied at  Club ExerciseDaily  before ?
 
Employment History
Employer Position Duration Supervisor (Name & Phone)
 
Education History
School Degree Years
 
Criminal History
Have you ever been arrested? Yes No
If Yes, please provide reason and dates of arrest. Reason
From : To:
Have you ever been convicted of a felony? Yes No
If Yes, please explain
 
References
Name Address Phone Number How long you have
known her/him?
 
I pledge under penalty or perjury that the above information is accurate and correct to the best of my knowledge. I authorize a representative of Club ExerciseDaily, Inc. to review and investigate all claims put forth on this application. 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 any pertinent information they may have , personal or otherwise, and release Club ExerciseDaily, Inc. from all liability for any damage that may result from utilization of such information.  
 
Applicant : Date :
INTERVIEWD BY :  
 
 
 
 
 
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