Careers at Dismal River Club

First Name

Last Name

Address

City

State

Zip Code

Phone Number

Email Address

Have you previously applied for a position or worked for our company? Have you previously applied for a position or worked for our company? Yes No

If given a conditional offer can you: If given a conditional offer can you: Furnish proof that you are at least 18 years of age or, if under 18, eligible for employment? Furnish proof that you are eligible for employment in the United States?

Are there any special circumstances necessary for you to perform the job for which you are applying? Are there any special circumstances necessary for you to perform the job for which you are applying? Yes No

If yes, please explain

Position Desired

#hrs/wk and days of the week you are available

Select Highest Level of Education Select Highest Level of EducationGrade SchoolHigh SchoolJunior CollegeCollege

Summarize any experience, knowledge, skills, abilities, or specialized training you would like us to know about:

Most Recent Employer Company Name:

Employed From Date:

Employed To Date:

Reason For Leaving

Position Held

City, State, Zip

Supervisor Name

Phone Number

May we contact this employer? May we contact this employer? Yes No

2nd Employer Company Name:

Employed From Date:

Employed To Date:

Reason For Leaving

Position Held

City, State, Zip

Supervisor Name

Phone Number

May we contact this employer? May we contact this employer? Yes No

I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that falsification of information requested in this document or omission of information may disqualify me from further consideration for employment, or, if discovered after I am hired, may result in my immediate discharge from employment. * I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that falsification of information requested in this document or omission of information may disqualify me from further consideration for employment, or, if discovered after I am hired, may result in my immediate discharge from employment. * Yes

I authorize investigation of all statements contained herein and references listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to you. * I authorize investigation of all statements contained herein and references listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to you. * Yes

I understand and agree that this Employment Application does not constitute a contract of employment, and that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time for any or no reason, with or without prior notice. I also understand and agree that, if hired, the terms and conditions of my employment may be changed, with or without notice, at any time by Kemper Sports Management absent an enforceable, executed, written agreement to the contrary. * I understand and agree that this Employment Application does not constitute a contract of employment, and that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time for any or no reason, with or without prior notice. I also understand and agree that, if hired, the terms and conditions of my employment may be changed, with or without notice, at any time by Kemper Sports Management absent an enforceable, executed, written agreement to the contrary. * Yes

I understand that if selected for employment with the Company, I may be required to participate in a pre-employment drug testing program at a company authorized, licensed medical facility which includes screening for the presence of controlled substances. I understand that the results will be kept strictly confidential. I hereby release Kemper Sports Management, any employees or agents thereof from any and all claims or causes of action resulting therefrom. * I understand that if selected for employment with the Company, I may be required to participate in a pre-employment drug testing program at a company authorized, licensed medical facility which includes screening for the presence of controlled substances. I understand that the results will be kept strictly confidential. I hereby release Kemper Sports Management, any employees or agents thereof from any and all claims or causes of action resulting therefrom. * Yes