We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity Act. Applicants and/or employees are considered for hire, promotion, and job status without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability, or sexual orientation.

1. General Information:
Last Name First Name Middle Initial Date
Address City State Zip
Have you thoroughly read and understand the job descriptions listed on the club website?
Yes No
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation? Yes No
Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.)

No Yes If yes, explain

2. Education & Training:
Enter last grade completed – 1 2 3 4 5 6 7 8 9 10 11 12 College 1 2 3 4
Degree held – High School Associates Bachelors Master Doctorate
High School Attended and Address Major Course Studied Graduated (Y/N) Average Grade

College or University and Address Major Course Studied Graduated (Y/N) Average Grade

List any scholarships, academic honors, awards, or special achievements:

3. Skills:
Which position(s) are you applying for? (check all that apply)
A-Team Assistant Coach
B-Team Head Coach Freshmen Team Head Coach Girls Head Coach
B-Team Assistant Coach Freshmen Team Assistant Coach Girls Assistant Coach
Preferred Position:
Why are you qualified for this position?
Please list any skills you have that are appropriate for the position you are applying for:
Please list and describe all teaching and/or coaching experience for any subject/sport that you have:
Available days of the week to work 3-5pm:
Monday Tuesday Wednesday Thursday Friday Maximum days per week
Interests/Accomplishments: You may wish to list significant experience, interests, & accomplishments gained while working as a volunteer/coach/player that may be useful in the position(s) you are seeking.

4. Employment History
Starting with your PRESENT or MOST RECENT EMPLOYER list in consecutive order all employment for at least the past three employers. If currently employed, may we contact your employer? Yes No
Present or Most Recent Employer Full Name of Company
Street Address City State Zip
Name & Title of Supervisor Title of Your Position
List of Jobs Held, Duties Performed, Skills Used, & Promotions while Employed at This Company
Employed from (MO/YR) to (MO/YR)
Reason for Leaving:

Second Most Recent Employer Full Name of Company
Street Address City State Zip
Name & Title of Supervisor Title of Your Position
List of Jobs Held, Duties Performed, Skills Used, & Promotions while Employed at This Company
Employed from (MO/YR) to (MO/YR)
Reason for Leaving:

Third Most Recent Employer Full Name of Company
Street Address City State Zip
Name & Title of Supervisor Title of Your Position
List of Jobs Held, Duties Performed, Skills Used, & Promotions while Employed at This Company
Employed from (MO/YR) to (MO/YR)
Reason for Leaving:

READ CAREFULLY: I certify the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give Holy Mackerel Ultimate Club any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing those items to you.

Signature Date