RICTLY PROHIBITED TO DISTRIBUTE, PUBLISH, OFFER FOR SALE, LICENSE OR SUBLICENSE, GIVE OR DISCLOSE TO ANY OTHER PARTY, THIS A Nam: EMPLOYMENT SCREENING FORM PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS Las Fs Mddl Psn Addss: Da: Numb S Cy Sa Zp How Long a s addss: Socal Scuy No: Tlpon: Employmn Dsd: TYPE OF SCHOOL Hg Scool Collg Bus o Tad Scool Pofssonal Scool Da of B: FULL-TIME ONLY PART-TIME ONLY FULL- OR PART-TIME EDUCATION & OTHER INFORMATION NAME OF SCHOOL Landscap o lad Consucon Expnc Masony o Conc Expnc Plumbng o Elccal Expnc Spcal Cfcaons o Tanng Psonal Ys PC Compu No Mac LOCATION (Compl malng addss) WORK EXPERIENCE O Sklls: NO OF YEARS COMPLETED MAJOR & DEGREE C o p y g B z I n c 2 0 1 0 A l l g s s v d P o c d 1 Fou Sasons of Goga, LLC Employmn Scnng b y
EMPLOYMENT HISTORY Plas ls you wok xpnc fo pas fv yas bgnnng w you mos cn job Compl nfomaon blow w mos cn job ld If you w slf-mployd, gv fm nam Aac addonal ss f ncssay Job On Nam of Employ: Nam of Las Supvso Employmn Das Salay Compl Addss: Pon Numb: Rason fo Lavng (b spcfc): You Job Tl: Fom: Sa: Fnal: Ls jobs you ld, dus pfomd, sklls usd o land, advancmns o pomoons wl you wokd a s company Job Two Nam of Employ: Nam of Las Supvso: Employmn Das Salay Compl Addss: Pon Numb: You Job Tl: Fom: Sa: Fnal: Rason fo Lavng (b spcfc): Ls jobs you ld, dus pfomd, sklls usd o land, advancmns o pomoons wl you wokd a s company Job T Nam of Employ: Nam of Las Supvso: Employmn Das Salay Compl Addss: Pon Numb: You Job Tl: Fom: Sa: Fnal: Rason fo Lavng (b spcfc): Ls jobs you ld, dus pfomd, sklls usd o land, advancmns o pomoons wl you wokd a s company May w conac you psn mploy? Dd you compl s applcaon youslf? 2 Ys No Ys No Fou Sasons of Goga, LLC Employmn Scnng
MILITARY EXPERIENCE Hav you v bn n amd focs? Banc: A you now a mmb of Naonal Guad? Da End: Dscag Da: Duy Tl/Spcaly: Typ of Dscag: Hav you v bn convcd of a cm? CRIMINAL HISTORY If ys, xplan numb of convcon(s), nau of offns(s) ladng o convcon(s), ow cnly suc offns(s) was/w commd, snnc(s) mposd, and yp(s) of ablaon DRIVER HISTORY Dv Lcns# Sa of ssu: Hav you ad any moo vcl accdns? Expaon da: If ys, ow many? I s undsood and agd upon a any mspsnaon by m n s applcaon wll b suffcn caus fo cancllaon of s applcaon and/o spaaon fom mploy s svc f I av bn mployd Fumo, I undsand a I am f o sgn a any m, mploy svs g o mna my mploymn a any m, w o wou po noc I undsand a no psnav of mploy as auoy o mak any assuanc o conay I gv mploy g o nvsga all fncs and o scu addonal nfomaon abou m, f job lad I by las fom lably, mploy and s psnavs fo skng suc nfomaon and all o psons, copoaons, o oganzaons fo funsng suc nfomaon Applcan Sgnau: Da: 3 Fou Sasons of Goga, LLC Employmn Scnng
APPLICATION FORM WAIVER PLEASE READ CAREFULLY In xcang fo consdaon of my job applcaon by Fou Sasons of Goga, LLC (naf calld Company ), I ag a: N accpanc of s applcaon no subsqun ny no any yp of mploymn laonsp, n poson appld fo o any o poson, and gadlss of conns of mploy andbooks, psonnl manuals, bnf plans, polcy samns, and lk as y may xs fom m o m, o o Company paccs, sall sv o ca an acual o mpld conac of mploymn, o o conf any g o man an mploy of Fou Sasons of Goga, LLC, o ows o cang n any spc mploymn-a-wll laonsp bwn and undsgnd, and a laonsp canno b ald xcp by a wn nsumn sgnd by Psdn /Gnal Manag of Company Bo undsgnd and Fou Sasons of Goga, LLC may nd mploymn laonsp a any m, wou spcfd noc o ason If mployd, I undsand a Company may unlaally cang o vs bnfs, polcs and pocdus and suc cangs may nclud ducon n bnfs I auoz nvsgaon of all samns conand n s applcaon I undsand a mspsnaon o omsson of facs calld fo s caus fo dsmssal a any m wou any pvous noc I by gv Company pmsson o conac scools, pvous mploys (unlss ows ndcad), fncs, and os, and by las Company fom any lably as a sul of suc conac I also undsand a (1) Company as a dug and alcool polcy a povds fo p-mploymn sng as wll as sng af mploymn; (2) consn o and complanc w suc polcy s a condon of my mploymn; and (3) connud mploymn s basd on succssful passng of sng und suc polcy I fu undsand a connud mploymn may b basd on succssful passng of joblad pyscal xamnaons I undsand a, n conncon w oun pocssng of my mploymn applcaon, Company may qus fom a consum pong agncy an nvsgav consum po ncludng nfomaon as o my cd cods, caac, gnal puaon, psonal caacscs, and mod of lvng Upon wn qus fom m, Company, wll povd m w addonal nfomaon concnng nau and scop of any suc po qusd by, as qud by Fa Cd Rpong Ac As a condon of mploymn, I undsand a I mus povd a cfd copy of my cun DMV cod If I fal o povd a cfd copy of my cun DMV cod, Company wll oban a cfd copy, and all coss assocad w pocumn of sad cod wll b dducd fom fs (1 s ) payoll pod I undsand a, n conncon w oun pocssng of mploymn applcaon, Company may conac o sa and fdal agncs as ndd Any coss assocad w s backgound nvsgaons wll b bon by applcan and dducd n (1 s ) pay pod I fu undsand a my mploymn w Company sall b pobaonay fo a pod of nny (90) days, and fu a a any m dung pobaonay pod o af, my mploymn laon w Company s mnabl a wll fo any ason by pay Sgnau of Applcan: Da: Ts Company s an qual mploymn oppouny mploy W ad o a polcy of makng mploymn dcsons wou gad o ac, colo, lgon, sx, sxual onaon, naonal ogn, cznsp, ag o dsably W assu you a you oppouny fo mploymn w s Company dpnds solly on you qualfcaons Tank you fo akng m o compl s scnng and fo you ns n ou company 4 Fou Sasons of Goga, LLC Employmn Scnng
5 Fou Sasons of Goga, LLC Employmn Scnng