The Riverhouse | The Finest Resort in the Heart of Bend

Employment Opportunities:

Have you ever worked at The Riverhouse or River's Edge Golf Course before? Yes. If yes, when (mm/year) No.
Why are you applying at The Riverhouse today?
Classified ad Driving by Stayed here before Referred by:	Employee referral Word of mouth Internet job listing Other:		Reputation of The Riverhouse Referred by school
Personal Information: Name: Street Address: City, State, Zip: Telephone (Including Area Code): Employment Desired: Position Desired:		Date available to start (mm/dd/year): Days you can work: Hours you can work: Desired wage:

Education:
Schools	# Years Attended	Name of School - City	Major	Graduated
Grammar				Yes No
High				Yes No
College				Yes No
Other				Yes No

Military Service:
Armed Forces Service: Yes No
From (mm/year): To (mm/year): Branch:
Rank or rating at time of enlistment: Rank or rating at time of discharge:

Previous Employment:
Employer Name & Telephone (most current employer first)	Date Employed (mm/year)	Wage	Position & Description of Duties	Reason for Leaving
Firm Name: Telephone Number: (Including Area Code)	From: To:
Firm Name: Telephone Number: (Including Area Code)	From: To:
Firm Name: Telephone Number: (Including Area Code)	From: To:
Firm Name: Telephone Number: (Including Area Code)	From: To:

References: Give the names of three persons not related to you whom you have know at least one year. (At least two business oriented.)
Name:	Telephone Number:	# Years Known

Safety:
Have you received certified first aid training? Yes, Date Completed: No
Do you have a valid driver's license? Yes No
Have you completed any type of certified occupational safety or health training? Yes No
Type of training: Date Completed:
Have you ever been convicted of a felony? Yes No

Consent for Pre-Employment Drug Testing:
One part of the employment process includes testing for both alcohol and controlled substances. If you wish to complete the application process, you must consent to testing by checking the following box and be tested.

Checking the box indicates consent to testing on a specimen provided by you in order to determine the presence of alcohol or controlled substances and agreement that the results of an analysis will be used to determine eligibility for employment.

I consent to pre-employment drug testing.

Consent for Employment Ability and Health Screening:
Part of the employment process may include a health assessment and testing for physical abilities to perform the position you have been conditionally offered. If you wish to complete the employment process, you must consent to testing by checking the following box and be tested.

If you are found to be disabled, as defined by law, you may make written request to the Company for reasonable accommodation of the disability within the position for which you have been preliminarily selected.

I consent to employment ability and health screening.

Release of Information:
I hereby authorize the examining physician and/or assessment program personnel to release to Company information regarding my medical condition as it relates to the employment criteria and requirements of Company. I recognize that the information disclosed may contain information that is protected by federal and state law such as; ALCOHOL, DRUG ABUSE OR MENTAL HEALTH INFORMATION, obtained in the course of my assessment.

I understand the examining physician is not my physician and this assessment does not constitute a complete medical examination; it is an assessment to determine my eligibility for employment in a particular job classification.

I will provide true, correct and complete facts. I understand that misrepresentation or omission of facts will be grounds for being denied employment or for termination of employment. I specifically consent to the disclosure of such information for the purpose of becoming an employee of Company.

By checking this box I agree to the above release of information.

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For More Information: (541) 389-3111 • Toll Free: (866) 453-4480