fitness, nutrition, exercise: Brick Bodies Lynne Brick's Health Clubs

EMPLOYMENT APPLICATION FORM

PLEASE COMPLETE ALL ANSWERS BEFORE SUBMITTING.
Prospective employees will receive consideration without discrimination because of race, creed, color,
sex, age, national origin, handicap or veteran status.

Your Last Name:
Your First Name:
Your Middle Name/Initial:
Your Email:
Home Phone:(incl. area code)
Business Phone:(incl. area code)
Street Address:
City:
State:
Zip Code:
Are you currently a member of Brick Bodies?	No Yes
Preferred Brick Bodies Location:
Position You're Interested In:	Fitness Trainer Personal Trainer Health Club Sales Group Exercise Instructor Service Desk Childcare Internship (unpaid) Other(fill in)

Are you of the legal age to work? Yes No
Apart from absence for religious observance, are you available to work full-time? Yes No		If not, what hours can you work?(fill in)
Will you work overtime if asked? Yes No
Are you legally eligible for employment in the United States? Yes No

When will you be available to begin work?
Other special training or skills (languages, machine operation, etc.)

SCHOOL INFORMATION
School	Name/Location of School	Course of Study	No. Of Years Completed	Did You Graduate?	Degree or Diploma
Graduate				Yes No
College				Yes No
Business/Trade/ Technical/Other				Yes No
High School				Yes No

Membership in Professional or Civic Organizations (Exclude those which may disclose your race, color, religion or national origin.)
Please list any type of formal training you have had for the position for which you are applying.
Why are you interested in working for us?

EMPLOYMENT INFORMATION Please give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.
Company Name	Telephone (w/area code)
Company Address Name of Supervisor State Job title and Describe Your Work	Employed (month/year) From: Year: To: Year:
Weekly pay Start: Last:	Reason for Leaving:

Company Name	Telephone (w/area code)
Company Address Name of Supervisor State Job title and Describe Your Work	Employed (month/year) From: Year: To: Year:
Weekly pay Start: Last:	Reason for Leaving:

Company Name	Telephone (w/area code)
Company Address Name of Supervisor State Job title and Describe Your Work	Employed (month/year) From: Year: To: Year:
Weekly pay Start: Last:	Reason for Leaving:

Company Name	Telephone (w/area code)
Company Address Name of Supervisor State Job title and Describe Your Work	Employed (month/year) From: Year: To: Year:
Weekly pay Start: Last:	Reason for Leaving:
We may contact the employers listed above unless you indicate those you do not want us to contact.	Do Not Contact: Employer: Reason:

Did you serve in the U.S. Armed Forces? Yes No	If "Yes", what Branch?
Describe any training received relevant to the position for which you are applying.
Please list any awards that you have won that are relevant to the position:
Any other brief questions/comments:
How did you hear about Brick Bodies/Lynne Brick's? TV radio newsletter member referral sign print ad other

Please use this to confirm your form.

FORM SUBMISSION

Thank you for your employment request. When you submit, this will take you to a special thank you page. We will be in touch soon.

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