Employment Application

PERSONAL INFORMATION

Last Name* First Name* Middle Initial Home Phone*

Address* City* State* Zip*

Home E-mail Address*:

Are you 18 years of age or older?* Yes  No
Have you been convicited of a crime in the last seven years? Yes  No
if yes, list convictions that are a matter of public record, arrests are not convictions. a conviction will not necessarily disqualify you for employment.
Referred by*:

EMPLOYMENT DESIRED

Position *:	Location*:
Salary Desired*:
Date you can start:
Are you available to work overtime?* Yes  No	What is the minimum pay you desire?
Have you ever worked for Cardio Express, if yes, when, which location

Days and Hours You Are Available To Work:
Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday

EDUCATION
Type of School	Name/City & State	last year completed	Did you graduate?	Degrees received/subjects studied	List skills relevent to this position applied for
High School
College
Trade/Business School

GENERAL INFORMATION

Have you ever visited a Cardio Express location? Where? Describe your experience.

What do you like about fitness?

Why would you like to work for Cardio Express?

Describe a specific situation where you have provided excellent customer service in your most recent position. Why was this effective?

EMPLOYMENT HISTORY
Name of Company 1	Telephone Number
Street Address City State Zipcode	Name of Immediate Supervisor
Date of Employment         From: To:	Reason for Leaving
Position(s) Held	Salary

Name of Company 2	Telephone Number
Street Address City State Zipcode	Name of Immediate Supervisor
Date of Employment         From: To:	Reason for Leaving
Position(s) Held	Salary

Name of Company 3	Telephone Number
Street Address City State Zipcode	Name of Immediate Supervisor
Date of Employment         From: To:	Reason for Leaving
Position(s) Held	Salary

REFERENCES (Not related and known for at least one year) Supervisors preferred
Name	Complete Address	Phone	Years Known
Name	Complete Address	Phone	Years Known

APPLICANT'S CERTIFICATION

I hereby authorize Cardio Express to thoroughly investigate by background, references, employment record and other matters related to my suitability for employment. I authorize persons, schools, my current employer (if applicable), and previous employers and organizations contacted by Cardio Express to provide any relevant information regarding my current and/or previous employment and I release all person, schools, employers of any and all claims for providing such information. I understand that misrepresentation or omission of facts may result in refection of this application, or if hired, discipline up to and including dismissal. I understand that I may be required to sign a confidentiality and/or non compete agreement, should I become an employee of Cardio Express. I understand that nothing contained in this application, or conveyed during any interview which may be granted, is intended to create an employment contract. I understand that filling out this form does not indicate there is a position open and does not obligate Cardio Express to hire me. I understand and agree that my employment is at will, which means that it is for no specified period and may be terminated by me or Cardio Express at any time without prior notice for any reason.

I acknowledge that I have read this Certification and understand and agree with each of its terms.