Jeanetix Fitness, LLC

Application Form

Applicant Name:
Address:
Telephone Number:
Email Address:
Date of Application:

Employment Position
Position(s) you're applying for: Personal Trainer

How did you hear about this position?
What days are you available for work?
What hours or shift are you available for work?
On what date can you start working if you are hired?
Do you have reliable transportation to and from work?

Personal Information

Are you a U.S. citizen or approved to work in the United States?	Yes No
What document can you provide as proof of citizenship or legal status?
Have you ever been convicted of a criminal offense (felony or misdemeanor)?	Yes No
If yes, please state the nature of the crime(s), when and where convicted and disposition of the case:

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)



Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying:

(Note: Jeanetix Fitness, LLC complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/ agility.)

Education and Training

High School

Name
Location (City, State)
Year Graduated
Degree Earned

College/ University

Name
Location (City, State)
Year Graduated
Degree Earned

Vocational School/ Specialized Training

Name
Location (City, State)
Year Graduated
Degree Earned

Military

Are you a member of the Armed Services?
What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
What military skills do you possess that would be an asset for this position?

Previous Employment

Employer Name:
Job Title
Duties Performed
Supervisor Name
Employer Address
City, State, and Zip Code
Employer Telephone
Dates Employed
Reason for Leaving

Employer Name:
Job Title
Duties Performed
Supervisor Name
Employer Address
City, State, and Zip Code
Employer Telephone
Dates Employed
Reason for Leaving

Employer Name:
Job Title
Duties Performed
Supervisor Name
Employer Address
City, State, and Zip Code
Employer Telephone
Dates Employed
Reason for Leaving

RESUME, CERTIFICATES, LICENSES & OTHER DOCUMENTS

AT-WILL EMPLOYMENT

The relationship between you and the Jeanetix Fitness, LLC is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the Jeanetix Fitness, LLC. No representative of Jeanetix Fitness, LLC has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice-President/ Chief Operations Officer or the Company's President. I understand that I may be asked to submit employment eligibility verification as required by Texas and/ or the U.S. Department of Justice and the Immigration and Naturalization Service.

I, acknowledge that I am of legal age and I hereby consent to the use of an electronic signature to record my agreement with the terms of the Employment Application as of . I, certify that the answers given herein are true and complete to the best of my knowledge.

E-Signature

Date