Application - Palo Alto Hills Golf and Country Club

This Employer
Participates in E-Verify
This employer will provide the Social Security Administration
In order to determine whether Form I-9 documentation is valid,
(SSA) and, if necessary, the Department of Homeland Security
this employer uses E-Verify’s photo screening tool to match
(DHS), with information from each new
employee’s Form I-9 to confirm work
authorization.
IMPORTANT: If the Government cannot
confirm that you are authorized to work,
this employer is required to provide you
written instructions and an opportunity
to contact SSA and/or DHS before taking
adverse action against you, including
the photograph appearing on some
N O T I C E:
permanent resident and employment
Federal law requires
all employers
to verify the identity and
employment eligibility
of all persons hired to work
in the United States.
Citizenship and Immigration Services’
terminating your employment.
authorization cards with the official U.S.
(USCIS) photograph.
If you believe that your employer has
violated its responsibilities under this
program or has discriminated against
you
during
the
verification
process
based upon your national origin or
citizenship status, please call the Office of Special Counsel at
Employers may not use E-Verify to pre-screen job applicants or
to re-verify current employees and may not limit or influence the
choice of documents presented for use on the Form I-9.
For more information on E-Verify,
please contact DHS at:
1-888-464-4218
1-800-255-7688 (TDD: 1-800-237-2515).
Este Empleador
Participa en E-Verify
Este empleador le proporcionará a la Administración del Seguro
Social (SSA), y si es necesario, al Departamento de Seguridad
Nacional (DHS), información obtenida del Formulario I-9
correspondiente a cada empleado
recién contratado con el propósito de
confirmar la autorización de trabajo.
IMPORTANTE: En dado caso que el
gobierno no pueda confirmar si está
usted autorizado para trabajar, este
empleador está obligado a proporcionarle
las instrucciones por escrito y darle la
oportunidad a que se ponga en contacto
con la oficina del SSA y, o el DHS antes
de tomar una determinación adversa en
contra suya, inclusive despedirlo.
A V I S O:
La Ley Federal le exige a
todos los empleadores
que verifiquen la identidad y
elegibilidad de empleo
de toda persona contratada
para trabajar en
los Estados Unidos.
Los empleadores no pueden utilizar
E-Verify con el propósito de realizar una preselección de
aspirantes a empleo o para hacer nuevas verificaciones de
los empleados actuales, y no deben restringir o influenciar la
Employment Verification.
selección de los documentos que sean presentados para ser
utilizados en el Formulario I-9.
A fin de poder determinar si la
documentación del Formulario I-9 es
valida o no, este empleador utiliza la
herramienta de selección fotográfica de
E-Verify para comparar la fotografía que
aparece en algunas de las tarjetas de
residente y autorizaciones de empleo,
con las fotografías oficiales del Servicio
de Inmigración y Ciudadanía de los
Estados Unidos (USCIS).
Si usted cree que su empleador ha
violado sus responsabilidades bajo este
programa, o ha discriminado en contra
suya durante el proceso de verificación
debido a su lugar de origen o condición de ciudadanía, favor
ponerse en contacto con la Oficina de Asesoría Especial
llamando al 1-800-255-7688 (TDD: 1-800-237-2515).
Done.
Para mayor información sobre E-Verify, favor ponerse
en contacto con la oficina del DHS llamando al:
1-888-464-4218
The E-Verify logo and mark are registered trademarks of Department of Homeland Security. Commercial sale of this poster is strictly prohibited.
M-780 (rev. 12/2010)
Palo Alto Hills Golf and Country Club
3000 Alexis Drive
Palo Alto, CA 94304
Application for Employment
We are an equal opportunity employer and do not unlawfully discriminate in employment. No
question on this application is used for the purpose of limiting or excluding any applicant from
consideration for employment on a basis prohibited by local, state, or federal law. Equal access
to employment, services, and programs is available to all persons. Those applicants requiring
reasonable accommodation to the application and/or interview process should notify a
representative of the organization.
Applicant name:
Date:
Position(s) applied for or type of work desired:
Address:
Telephone #:
Type of employment desired:
Social Security #:
______ full-time
______ part-time
______ temporary
Date you will be available to start work:
Are you able to meet the attendance requirements?
Yes
No
Yes
No
Do you have any objection to working overtime if necessary?
Can you travel if required by this position?
Yes
No
Have you ever been previously employed by Palo Alto Hills G&CC?
Yes
No
Do you have any friends or relatives working here?
______ Yes ______ No
If you anwered yes, who?_______________________________________________________
Can you submit proof of legal employment authorization and identity?
Yes
No
If you are under 18, can you furnish a work permit if it is required?
Yes
No
Have you ever been convicted of a felony in the last 7 years?
Yes
No
If yes, please explain (a conviction will not automatically bar employment):
Drivers license number (if driving is an essential job duty):
How were you referred to us?
Employment History
Please provide all employment information for your past four employers starting with the most recent.
Employer:
Address:
Immediate supervisor and title:
ates employed: from
Job summary:
Reason for leaving:
Employer:
Address:
Immediate supervisor and title:
Dates employed: from
Job summary:
Reason for leaving:
Employer:
Address:
Immediate supervisor and title:
Dates employed: from
Job summary:
Reason for leaving:
Employer:
Address:
Immediate supervisor and title:
Dates employed: from
Job summary:
Reason for leaving:
Position held:
Telephone #:
to
Salary:
Position held:
Telephone #:
to
Salary:
Position held:
Telephone #:
to
Salary:
Position held:
Telephone #:
to
Salary:
Other Skills and Qualifications
Summarize any job-related training, skills, licenses, certificates, and/or other qualifications:
Educational History
List school name and location, years completed, course of study, and any degrees earned:
High school:
College:
Technical Training:
Other:
References
List 3 references names, telephone numbers, and years known (do not include relatives):
I hereby authorize Palo Alto Hills Golf and Country Club to contact, obtain, and verify the
accuracy of information contained in this application from all previous employers, educational
institutions, and references. I also hereby release Palo Alto Hills Golf and Country Club and its
representatives for seeking, gathering, and using such information to make employment
decisions and all other persons or organizations for providing such information.
I understand that any misrepresentation or material omission made by me on this application will
be sufficient cause for cancellation of this application or immediate termination of employment
if I am employed, whenever it may be discovered.
If I am employed, I acknowledge that there is no specified length of employment and that this
application does not constitute an agreement or contract for employment. Accordingly, either I or
the employer can terminate the relationship at will, with or without cause, at any time, so long as
there is no violation of applicable federal or state law.
I understand that it is the policy of Palo Alto Hills Golf and Country Club not to refuse to hire or
otherwise discriminate against a qualified individual with a disability because of that person’s
need for a reasonable accommodation as required by the ADA.
I also understand that if I am employed, I will be required to provide satisfactory proof of
identity and legal work authorization within three days of being hired. Failure to submit such
proof within the required time shall result in immediate termination of employment.
I represent and warrant that I have read and fully understand the foregoing, and that I seek
employment under these conditions.
Applicant signature:
Date: