ProtecHockey Ponds Ice Center 15 Worlds Fair Drive Somerset, NJ 08873 (732)868-9181 F (732)868-9182
Employment Application Position Applying For:
Applicant Information Last Name:
First Name:
M.I.
Street Address:
Apt/Unit #:
City: Phone:
State:
(
Date:
)
Zip Code:
Email Address:
Date Available:
Desired Salary:
Are you authorized to work in the United States?
□ Yes
□ No
Social Security #:
Have you ever worked for this company?
□ Yes
□ No
If yes, when?
Have you ever been convicted of a felony?
□ Yes
□ No
If yes, explain:
Education High School: From:
City, State: To:
□ Yes
Did you graduate?
College:
□ No
Degree:
□ No
Degree:
□ No
Degree/License:
City, State:
From:
To:
□ Yes
Did you graduate?
Other:
City, State:
From:
To:
□ Yes
Did you graduate?
Employment History Company: Phone:
City, State:
(
)
Supervisor:
Job Title:
Starting Salary:
From:
To:
Company: Phone:
8/10
Reason for Leaving: City, State:
(
)
Supervisor:
Job Title: From:
Ending Salary:
Starting Salary: To:
Ending Salary:
Reason for Leaving: ProtecHockey Ponds, LLC 15 Worlds Fair Drive, Somerset, NJ 08873 (732)868-9181 F (732)868-9182
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Employment History Continued Company: Phone:
City, State:
(
)
Supervisor:
Job Title: From:
Starting Salary: To:
Ending Salary:
Reason for Leaving:
References Please list two (2) professional references (direct supervisors preferably) and one (1) personal reference. Full Name: Relationship: Company:
Title:
Years of Association:
Phone:
Full Name:
Relationship:
Company:
Title:
Years of Association:
Phone:
Full Name:
Relationship:
Company:
Title:
Years of Association:
Phone:
(
(
(
)
)
)
Transportation Do you have reliable transportation?
□ Yes
□ No
Disclaimer and Signature ProtecHockey Ponds, LLC is an Equal Employment Opportunity employer and complies with all applicable civil rights statutes. The company recruits, hires, trains, promotes, discharges, provides benefits and undertakes other personnel actions without regard to race, color, national origin, ancestry, age, sex, sexual orientation, transgender status, marital status, medical condition, disability, pregnancy, religion, veteran status, or other characteristic protected by applicable statute. “I certify that all information contained in this application and any attachments, including my resume, is true and correct to the best of my knowledge. I understand that any misrepresentation or material omission may result in my failure to receive an offer of employment, or if I am hired prior to the discovery of the misrepresentation of material omission my immediate dismissal from employment. I authorize my references and former employers to provide all requested information concerning my background and previous employment. Further, I agree to release ProtecHockey Ponds, LLC, my references, and my former employers from any and all liability arising from the furnishing, use, or disclosure of such information by any of the above parties or their agents. I understand that any offer of employment which I may receive is conditioned upon my providing satisfactory proof of my identity and my legal ability to work in the United States.” Signature:
8/10
Date:
ProtecHockey Ponds, LLC 15 Worlds Fair Drive, Somerset, NJ 08873 (732)868-9181 F (732)868-9182
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