Home Games Planning Events About

Application For Employment

Fields marked with an * are required.

Xtreem Family Fun is an equal opportunity employer dedicated to a policy of nondiscrimination in employment upon any basis, including race, color, creed, religion, age, sex, national origin, ancestry, marital status, or the presence of any physical or mental condition or disability. In reading and answering the following questions, please keep in mind that these questions are not intended to imply any limitations, illegal preferences, or discrimination based upon any non-job related information.

Last Name * First Name * Middle Initial

Address *

City * State * Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code *

Telephone * Cell phone Email

Are You Over 18 Years Of Age? * Yes No

Other Names Under Which You Have Been Previously Employed

Status Desired Full Time Part Time Weekends Overtime (If Required)

Position Desired Salary Desired Date You Can Start / /

Hour Available (Indicate AM/PM)     Mon-Fri To    Sat To    Sun To

Are You Currently Employed? Yes No

May We Contact Your Current Employer? Yes No

Have You Ever Been Employed By Xtreem Family Fun? Yes No

If Yes, When And Where?

List Names Of Relatives, Friends Or Acquaintances Currently Employed At Xtreem Family Fun

Do You Have A Valid Drivers License? * Yes No      If Yes, #

Can You, After Employment, Submit Verification Of Your Legal Right To Work In The United States? * Yes No

Education
Type of School	Name and Location of School	# of Years	Major	Graduate Y or N	Diploma Received?
High School				Yes No	Yes No
Business/Trade School				Yes No	Yes No
College or University				Yes No	Yes No

References
List two past supervisors and one person who is not related to you who have knowledge of your qualifications for the position for which you are applying.
Name	Title/Relationship	Address (street, city, state, zip code)	Phone Number	Occupation

Are You Currently Or Were You Previously In The Military? List Brance (Including Reserves)

Have You Ever Been Convicted Of A Crime (Misdemeanor Or Felony)? A Conviction Will Not Necessarily Disqualify You From Employment: Failure To Disclose Can Be Grounds For Termination. * Yes No

If Yes, Please Explain Fully. State The Nature Of The Offense, Date And Location The Offense Took Place:

EMPLOYMENT RECORD

From: Mo Yr To: Mo Yr

Business Name Phone #

Address City State Zip

Job Title Duties

Supervisor Title

Rate Of Pay Per

Reason For Leaving

From: Mo Yr To: Mo Yr

Business Name Phone #

Address City State Zip

Job Title Duties

Supervisor Title

Rate Of Pay Per

Reason For Leaving

From: Mo Yr To: Mo Yr

Business Name Phone #

Address City State Zip

Job Title Duties

Supervisor Title

Rate Of Pay Per

Reason For Leaving

From: Mo Yr To: Mo Yr

Business Name Phone #

Address City State Zip

Job Title Duties

Supervisor Title

Rate Of Pay Per

Reason For Leaving

UNEMPLOYMENT HISTORY

Please Account For Any Time You Were Not Employed In The Last Seven Years, After Leaving School. (You Need Not List Any Unemployment Periods Of One Month Or Less)

Time Period	Reason For Unemployment

Have You Ever Been Discharged Or Asked To Resign From A Job? Yes No

If Yes, Why?

Whom Should We Contact In An Emergency? Phone #

I declare that the information provided by me on this application, or any other documents filled out in connection with my employment, is complete and true to the best of my knowledge. I understand that any misrepresentation or omission on this application may preclude an offer of employment or withdrawal of an employment offer or may result in my discharge from employment if I am already employed at the time the misrepresentation or omission is discovered. If employed by Xtreem Family Fun, Inc. and in consideration of my employment, I agree to abide by the rules and regulations of Xtreem Family Fun, Inc. and agree that my employment and compensation can be terminated at will, with or without cause, with or without notice, at any time, either at my option or at the option of Xtreem Family Fun, Inc. I authorize the investigation of all statements contained in this application. I also authorize the company to contact my present employer (unless otherwise noted in this application), past employers, and listed references and to provide information without limitations pertaining to my character, work history, background and qualifications. I waive any rights to privacy attached hereto. I release all parties and persons from any and all liability for any damages that may result from furnishing such information to Xtreem Family Fun, Inc. as well as from the use or disclosure of such information by Xtreem Family Fun, Inc. or any of its agents, associates, representatives or franchisor. As a condition of my employment, I agree to arbitrate any and all disputes with the company pursuant to an arbitration agreement to be presented to me by the company. I understand if selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States. I understand that all employment is contingent upon successful drug and/or alcohol screening and criminal background checks. Failure to keep my appointment for the drug/alcohol screening will result in withdrawal of a job offer.

Applicant Signature * Date *