Basic Information
Name:
Address:
City:
State:
Zip Code:
Home Phone #:
Cell Phone #:
E-mail:

Dates Available to Work this Season
First Day:
Last Day:
Are you free on the weekends before the above start date?	- Choose an Option - Yes No

Requested Information
Position Desired:	- Choose an Option - Activities Director Lifeguard (certification required) Kitchen Staff Busser Grounds Keeping Unsure
How did you hear of us? (If from current Employee, please note name here.)

Former Employment
List former Employers, if any
Reason For Leaving
Rate of Pay

Other Information
Years of schooling completed
Name of Most Recently Attended School
Extra-Curricular Activities: (Sports, Music, Etc.)

United States Military Service
Branch of Service:
Rank Attained:

Other
Are you a United States citizen?	- Choose an Option - Yes No
If "No", do you have a legal right and the necessary documentation to work in the United States?	- Choose an Option - Yes No
Have you ever been convicted of a crime other than a minor traffic violation? (NOTE: You are not required to disclose any arrest, charge, or conviction that has been erased under Connecticut General Statutes. The existence of a criminal record may not automatically disqualify you from the job for which you are applying.)	- Choose an Option - Yes No
If "Yes", Please use the space to explain the offense and the final disposition.

In making this application for employment, I represent that the above information is true and correct according to the best of my knowledge. I also understand that if I am accepted for employment, such employment will be “at will”. That is, either High Meadow Management Company or I may end the employment relationship at any time, for any reason, or for no reason. I understand that this application does not imply employment nor is it a contract of employment. I understand that, with my authorization, an investigation may be made whereby information is obtained regarding my character, previous employment, general reputation, educational background, credit record and/or criminal history.

Your Name and Date of Application: