Job Application: Referee – Adult Volleyball League Personal Information Last name * First name * Present address * City * State * Zip code * Phone number * Email address * Referred by Application Form Are you 18 years of age or older? Yes No If you are under 16 years of age and it is required, can you furnish a work permit? Yes No Employment Desired Position Date you can start Salary desired Are you employed? Yes No If so, may we inquire of your present employer? Yes No Supervisor name and phone number Ever applied to this company before? Yes No Where? When? Desired number of hours per week? Days available Monday Tuesday Wednesday Thursday Friday Saturday Sunday Times available Morning Afternoon Evening Education History High School Name & location # years attended Did you graduate? Subjects studied College Name & location # years attended Did you graduate? Subjects studied Trade, Business or other school Name & location # years attended Did you graduate? Subjects studied General Information Please list certifications or special training/skills U.S. Military or Naval service Rank Former Employers List below last four employers, starting with last one first From To Name/addr/tel … Position Reason for leaving From To Name/addr/tel … Position Reason for leaving From To Name/addr/tel … Position Reason for leaving From To Name/addr/tel … Position Reason for leaving References Please list three references not related to you and whom you have known at least one year. Name Address Phone Number Relationship Name Address Phone Number Relationship Name Address Phone Number Relationship Optional info for Federal Government The following information is requested by the Federal Government in order to monitor compliance with Federal Laws prohibiting discrimination against applicants seeking to participate in the program. You are not required to furnish this information but are encouraged to do so. This information will not be used in evaluating your application or to discriminate against you in any way. However, if you choose not to furnish it, we are required to note the race/national origin of individual applicants on the basis of visual observation or surname. I do not wish to furnish this information Ethnicity: Hispanic or Latino Not Hispanic or Latino Race: White Black or African American American Indian or Alaskan Native Asian Native Hawaiian or Other Pacific Islander File Upload & Authorization Resume Click the button below if you wish to upload your resume along with your application. Cover letter (or other file to upload) Click the button below if you wish to upload another file along with your application. 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 any 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. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the American with Disabilities Act (ADA) and other relevant federal and state laws.” Agreement * Check here if you accept these terms Type your name as your digital signature and check the box below: *
