Richland Country Club Application for Employment

(We are an equal opportunity employer)

I understand that Richland Country Club is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion, transfer, and compensation to all qualified applicants and employees without regard to age, face, color, national origin, sex, religion, handicap or disability, or any other category protected by federal, state or local law.

I authorize former and present employers, work and personal references listed in the application, and any other individuals I may name, to give the Club or its designee -any and all information·concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability for any damages that may result from furnishing same to the Club. I also·authorize the Club to provide truthful information concerning my employment with it to future employers and I agree to hold it harmless for providing such information.

I understand that the Club reserves the right, to the extent permitted by law, to require drug screening tests of an applicant or an employee either prior to employment or any time during employment and I hereby give my consent to any such tests. I consent to the release of the results of any such tests to the Club or its designees. I release the Club and its designee from any and all liability and damages which may result or arise from any drug test or the provision of information in connection with such a test.

I understand that this employment application and any other Club documents are not promises of employment. Should I be employed, I understand that my employment will be on a trial period for ninety days from the date of my hiring. I further understand that, if I am employed, I can terminate my employment at any time with or without cause and with or without advance notice, and that the Club has a similar right. I understand that no manager, representative, or agent of the Club has any authority to enter into any agreement for employment for any specified period of time, or to. make any agreement contrary to the foregoing, except that a corporate officer may do so in writing.

The information given by me on this application and during the interview process is true and complete in all respects, and I agree that if the information is found to be false, misleading or unsatisfactory in any respect (in the Club's judgment) that I will be disqualified from consideration for employment or subject to immediate dismissal if discovered after I am hired.

THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF THIRTY (30) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY.

DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THIS STATEMENT

Each inquiry on this application must be fully answered and completed. Otherwise, you will not be considered for employment.

Answering "yes" to this question does not automatically bar employment here.

Please list the names of your present or previous employers in chronological order with present or last employer listed first If self-employed, give firm name and supply business references.

Please indicate any actual experience you have in any of the following positions:

Please fill out what days and hours you will be available to work.

I agree to submit to blood, breath, or urinalysis test to determine whether I have drugs in my system, or once employed, have a blood alcohol level above zero while on duty or on Club property. I understand that if I test positive for the presence of drugs or have the stated blood alcohol level, I will be subject to disqualification from hire, or discipline up to and including immediate discharge.

I consent to the release of my test results to Richland Country Club ("the Club") and its medical advisor. I also consent to the release of test -related information to the Club's insurers, the state unemployment compensation commission or any other governmental agency or court of law investigating my employment.

In return for my initial continued employment, I release the Club, its affiliates, and their associates, officers, agents, and employees from liability and damages which may arise from collection and testing of any specimen, or any adverse employment action taken as a result of the testing or test results.

I understand that this consent and release in no way limits my rights or the Club's right to terminate my employment at any time for any reason, with or without advanced notice.

Richland Country Club ("COMPANY") may obtain from Five Diamond Screening, LLC, ("5DS") P.O. Box 93983, Las Vegas, NV 89195-0013, 888.997.9308, www.5dscreening.com, a consumer report and/or an investigative consumer report ("REPORT") that contains background information about you in connection with your employment or employment application. If you are hired, to the extent permitted by law, COMPANY may obtain from 5DS further reports throughout your employment for an employment purpose without providing further disclosure or obtaining additional consent.

The REPORT may contain information about your character, general reputation, personal characteristics and mode of living. The REPORT may include, but is not limited to, credit reports and credit history information; criminal and other public records and history; public court records (e.g., bankruptcies, tax liens and judgments); motor vehicle and driving records; educational and employment history, including professional disciplinary actions; drug/alcohol test results; and Social Security verification and address history, subject to any limitations imposed by applicable federal and state law. This information may be obtained from public record and private sources, including credit bureaus, government agencies and judicial records, former employers and educational institutions, and other sources. If an investigative consumer REPORT is obtained, in addition to the description above, the nature and scope of any such REPORT will be employment verification and references, or personal references.

I have read the Disclosure Regarding Employment Background Report provided by Richland Country Club ("COMPANY") and this Authorization and Release to Obtain Information. By my signature below, I hereby consent to the preparation by Five Diamond Screening, LLC ("5DS"), a consumer reporting agency who can be contacted at P.O. Box 93983, Las Vegas, NV 89195, 888.997.9308, and www.5dscreening.com of background reports regarding me and the release of such reports to the COMPANY and its designated representatives, to assist the COMPANY in making an employment decision involving me at any time after receipt of this authorization and throughout my employment, to the extent permitted by law. To this end, I hereby authorize without reservation, any state or federal law enforcement agency or court, educational institution, motor vehicle record agency, credit bureau or other information service bureau or data repository, or employer to furnish any and all information regarding me to 5DS and/or the COMPANY itself, and authorize 5DS to provide such information to the COMPANY. I agree that a facsimile ("fax"), electronic or photographic copy of this Authorization shall be as valid as the original.

I acknowledge receipt of a copy of the Consumer Financial Protection Bureau's "A SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT."

I further understand that under the FCRA, I may request a copy of any consumer report from the consumer reporting agency that compiled the report, after I have provided proper identification. Where permitted, this authorization shall remain in effect over the course of my employment and reports may be ordered periodically during the course of my employment.

Additionally, I hereby attest that the information provided below is true and complete.

Information Needed to Complete the Background Report:
This information is being collected only for the use of conducting the background check and will not be taken into consideration in any employment decision and will not be used for any other purposes.