Employment Application

Hermitage Country Club, Inc. does not discriminate against applicants or employees because of their age, race, color, religions, national origin, sex, or any other basis prohibited by law. Furthermore, Hermitage Country Club, Inc. will not discriminate against any applicant or employee because he or she is mentally or physically disabled provided he or she is qualified and meet the requirements established by Hermitage Country Club, Inc.

Personal Information

Type of Position Desired

To comply with the Immigration Reform and Control Act of 1986, if you are hired you will be required to provide documents to establish your identity and your authorization to be employed in the United States. Such documents will be required before your first day of hire.

(Disclosure of a criminal record will not necessarily disqualify you for employment. Each conviction will be evaluated on its merits with respect to time, circumstances and seriousness, in relation to the job for which you are applying.)

Education - High School

Education - College/University

Education - Other


Military Service

Experience - Most Relevant Only

Additional Experience


(Individual Familiar With Your Work Ability - Do Not Include Relatives)

Reference 1

Reference 2

Certification and Release

I hereby certify that all statements made in this application are true are correct to the best of my knowledge and belief. I understand and agree that any misrepresentation or omission of facts in my application may be justification for refusal to hire, or termination of employment.

I further understand that an investigative report may be made as to my character and general reputation. I authorize all past employers, schools, persons and organizations having relevant information or knowledge to provide it to Hermitage Country Club, Inc. or its duly authorized representative for its use in deciding whether or not to offer me employment and specifically waive any required written notification. I hereby release employers, schools, persons and organizations from all liability in responding to inquires in connection with my application.

I understand that nothing in this employment application or in the granting of an interview is intended to create an employment contract between Hermitage Country Club, Inc. and me for either employment or for the providing of the benefit. If an employment relationship is established, I understand that my employment can be terminated, with or without cause, at the option of either Hermitage Country Club, Inc. or myself.

In signing this form, I certify that I understand all the questions and statements in this application.

If you are having trouble submitting this application, please contact Crystal Frankart at 804.708.8928.

* Bold Fields are Required