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SPORTS CENTER OFFICE
200 Bloomfield Avenue
West Hartford, CT 06117
Position Interested in: Type of Employment ___*__Monitor (Front Desk, Equipment Room,) _____regular
_____Lifeguard (must be certified)
__*___Office Assistant Semester applying for:
__*__Athletic Equipment Room Monitor __*___Fall
_____Game Management/Event Staff ___*__Spring
_____ Concessions _____Summer
Date available to start work: _______10/19/2016____________________
Name: Ashley Marie Antoine Student I.D. number: 19653722
Home address: ______237 Greenfield Street, Hartford CT, 06112
Cell phone: 860-985-0909 Email address: email@example.com
Date of birth: _____09/29/1998__ Univ of Hartford Student: __*____yes ______no
Have you previously been employed at the University of Hartford? ______yes __*___no
If yes: Department: _____________________________ Supervisor: _____________________________________
Dates of employment: From ________ to____________ Hourly rate $_________________
Employment Record (most recent):
Employer:Peter Seaman Phone: 860-543-8618
Job Title: Pro shop staff: Cashier
Address: 171 Windsor Ave, Windsor CT, 06095 Supervisor:_____Gary Devaux
Duties: Schedule tee times, restocking/inventory, sell merchandise
Have you ever been convicted of any violations? No If yes please explain: _____________________________________________
Have any on campus judicial charges been brought against you? _No____ If yes please explain: _________________________________________________________________________________________________
References (not related to you)
1) Name: Peter Seaman Phone: __860-543-8618___________________
Address: ___171 Windsor Ave, Windsor CT, 06095_____________
Relationship: Former employer _______
Name:Lucy Richard_______ Phone:_____860-768-5374____________
Address: _______200 Bloomfield Ave, West Hartford CT, 06117
Relationship: _________University of Hartford Advisor
Please write a brief statement describing any qualities and experience you possesses which would qualify you for this job. (If technical or medical, please specify).
I feel as though I am qualified for this job because of my ability to do my best at whatever challenge I am faced with. I have experience
working in a golf course professional shop, and this required me to interact with a variety of different people, and to preform quality customer service. Lastly but certainly not least I am able to deal with difficult situations regarding customer service, and handle them professionally enough to have the customer walk away satisfied.
Please fill in the hours you are available to work.
I certify that the information on this form is true to the best of my knowledge and I understand that ay false statements will be sufficient cause for dismissal from employment. I authorize the University to conduct any necessary and reasonable investigation with respect to the information provided above including contacting any persons named herein. In addition, if employed, I agree to abide by any and all University rules and regulations.
Signature: ______________Ashley Marie Antoine___________________ Date: _________10/18/16__________________
For Office Use Only
Application Date: _________________ Salary Rate: _____________ Interview Date: _________________
Clearance Date: ___________________________