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Employment Application

Step 1 of 7 - Personal Information

14%

Personal Information
Today's Date
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Birthdate*
MM
DD
YYYY
Age*
Email*
Are you a U.S. citizen or have the legal right to work in the U.S.?*
- Yes
- No
Have you been convicted of anything beyond a traffic violation?*
- No
- Yes
If Yes, explain:

Position, Wages & Availability
Please check the position(s) for which you are applying:
- Class Instructor +
- Weekend Events Personnel *+
- Member Services (Front Desk) Personnel *
- Gymnastics Team Coach +
* Requires light cleaning and the ability to multitask. + Requires ability to intermittently lift up to 50 pounds in order to assist members in training.
Desired hourly wage:
Hourly wage in dollars
Date available to start:
If applying for an EVENTS position, hours vary from week to week. Is this okay?
- Yes
- No
Please write your hours of availability for morning and afternoon/evening shifts:
Sunday: AM: PM: Monday: AM: PM: Tuesday: AM: PM: Wednesday: AM: PM: Thursday: AM: PM: Friday: AM: PM: Saturday: AM: PM:

Education
High School
Name and city location of school.
Years Completed
Graduated?
- Yes
- No
College
Name and city location of school.
Years Completed
Graduated?
- Yes
- No
Major / Course of Study

Employment History (Most Recent)
Company
Address
Street Address City State ZIP Code
Phone
Name of Immediate Supervisor
Dates of Employment
Wage or Salary Amount
Job Title
Reason for Leaving?
If currently employed here, is it okay to contact your supervisor?
- Yes
- No
Please describe your responsibilities.
Enter another employer?
- Yes
- No

Company
Address
Street Address City State ZIP Code
Phone
Name of Immediate Supervisor
Dates of Employment
Wage or Salary Amount
Job Title
Reason for Leaving?
If currently employed here, is it okay to contact your supervisor?
- Yes
- No
Please describe your responsibilities.

References (Provide Three)
Name
Relationship
Years Known
Phone
Name
Relationship
Years Known
Phone
Name
Relationship
Years Known
Phone

Personal Statement
Personal Statement
Describe your character strengths and any movement background. Attach another page or résumé if desired.

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Cheyenne Mountain
1789 South 8th Street
Colorado Springs, CO 80905

Lincoln Center
2727 North Cascade Ave
Colorado Springs, CO 80907

719.578.1006
info [at] flipshack.com