The First Tee of Denver

THE FIRST TEE OF DENVER

2017 INSTRUCTOR APPLICATION

Name ______

E-mail Address ______

Address______

StreetCityStateZip

Home Phone (____)______Cell Phone (____)______

Work Phone (____)______Can you be called at work? Y or N

Preferred Method of Communication: Email Home Phone Cell Phone Work Phone

(circle one)

Employer/School Name

______

Occupation

______

Present/Previous Volunteer Organization Affiliations and Contact Names:

______

Emergency Contact Information

______(___)_____-______

NamePhone Number

PGA or LPGA teaching professional. Y or N

If yes what level? ______

Please circle your answer:

1. Do you use illegal drugs?Yesor No

2. Have you been convicted of a crime other than a minor traffic offense? Yes or No

3. Has your driver’s license been suspended or revoked in any state?

Yes or No

If you answered yes to any of the above questions, please provide a written explanation with this application. Answering yes to any of the above questions does not necessarily preclude you from participation as an instructor. The offense and how recently you were convicted will be evaluated in relation to the instructor position for which you are applying.

We do not accept applicants who have been guilty of any type of assault; crimes against children; arson; possession or use of any drug; or sex related crimes.

Please list two NON-FAMILY references:

1. Name______

Address ______

Home Phone (_____) ______Work Phone (____)______

2. Name______

Address______

Home Phone (_____)______Work Phone(_____)______

Non-Discrimination Policy/Equal Opportunity Employer

The First Tee of Denver is committed to providing an inclusive and welcoming environment for all members of our community and to ensuring that employment decisions are based on individuals’ abilities and qualifications.

Consistent with this principle and applicable laws, it is therefore the policy of The First Tee of Denver not to discriminate in offering access to its programs and activities, or with respect to employment terms and conditions on the basis of race, color, gender, national origin, age, religion, creed, disability, veteran's status, sexual orientation, gender identity or gender expression. Such a policy ensures that only relevant factors are considered and that equitable and consistent standards of conduct and performance are applied.

I certify that I have given true, accurate and complete information on this form to the best of my knowledge. I understand that any false information or omission may be grounds for rejection of my application. I understand that if I am offered a position, I will be required to produce original documents verifying my identity and authorization to work in the United States in compliance with federal law.

I authorize previous employers, educational institutions, professional licensing boards and others to provide any information, including otherwise confidential or privileged information, requested by The First Tee of Denver in this evaluation and verification of this application and of my credentials and qualifications for employment status.

Signature______Date_____/____/____

Please return Application to:The First Tee of Denver

Attn: Erica Yates

2500 York St.

Denver, CO80205

Email: Fax: 720-865-3421

CERTIFICATION, AUTHORIZATION & WAIVER

REGARDING BACKGROUND CHECK

Certification

I certify that all statements in my application, resume and any other document I have submitted for a position with the Department of Parks and Recreation or the City and County of Denver are true, complete and correct to the best of my knowledge and belief. I further certify that all oral statements I have made or caused to be made to any representative of the Department of Parks and Recreation or the City and County of Denver are true, complete and correct to the best of my knowledge and belief. I understand and agree that ALL statements may be investigated.

I understand that any falsification or omission of information discovered at any time during the selection process or during subsequent employment, may bar me from consideration for a position of employment or, if I have been hired, cause my dismissal from the Department of Parks and Recreation or the City and County of Denver.

Authorization

I hereby authorize the Department of Parks and Recreation or the City and County of Denver, during the application process or during the course of any subsequent employment with the Department of Parks and Recreation or the City and County of Denver, to obtain information from any source as to my education, experience, qualifications, driving record, criminal history or any other aspect of my background, as such information relates to the position for which I am being considered, or in which I may be employed. In order to facilitate a search for information, I hereby confirm the following:

Full Legal Name (Print)______

First Middle (Must Include Middle Name) Last

Date of Birth: _____MM/_____DD/______YYYY (this is used for criminal and driving records)

Social Security Number: ______- ______- ______

Driver's License Number or State ID Number: ______State: _____

Current Address: ______

Street Address

______

Email Address: ______(Required)

City State ZIP

Length of Residency: ______

If length of residency is less than 7 years please provide previous addresses on a separate sheet of paper or on back.

Waiver

I release and waive any claim or cause of action against any person responding to inquires authorized herein, and against the Department of Parks and Recreation or the City and County of Denver in making such inquires.

A photocopy of this certification, authorization and waiver shall be as valid as the original and may be used in its stead.

Signature ______Date ______

MM/DD/YYYY

Signature______Date______

Parent/Guardian if Under 18 MM/DD/YYYY