Shiftboard: Town & Country Sports and Health Club Registration

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Registration: Town & Country Sports and Health Club

If you have already registered for access to our online scheduling system and you have already received your welcome email message with your temporary password, please sign in using that password.

If you have not completed this form, thank you for taking a moment to complete and submit the following details.

Thank you for your patience, it might take a few hours or days until your registration has been processed.

An Equal Opportunity / Affirmative Action Employer: Town & Country does not discriminate on the basis of age, sex, race, color, National origin, religion, veteran status, physical or mental disability.

* required field

* First Name

* Last Name

* Email

* Zip/Postal Code

Primary or Home Phone

Mobile Phone

Other/Work Phone

Pager

Fax

Address

City

State/Province

Country

Position You're Applying for

Desired Salary

If other, please specify here.

Date of Application

Date Available

Date of Birth

Are you over 18 years of age?

Yes No

Are you willing to work any shift?

Yes No

SSN/TaxID

Did you Graduate high school?

Yes No

Name of High School

HS City and State

Did you graduate from college?

Yes No

Major or Concentration

Degree and Type

Name of College

College City and State

Please list any additional educational history here.

Please list any Technical Certifications, Licenses, Registrations, etc., you may have here.

Computer Skills (Software, Programming, etc.)

First EMPLOYER’S NAME AND ADDRESS

Start date

End Date

Supervisor's name and phone number

Job Title

Describe major duties

Reason for leaving

Second EMPLOYER’S NAME AND ADDRESS

START DATE

END DATE

SUPERVISOR'S NAME AND PHONE NUMBER

JOB TITLE

DESCRIBE MAJOR DUTIES

REASON FOR LEAVING

Third EMPLOYER’S NAME AND ADDRESS

START DATE

End DATE

SUPERVISOR'S NAME AND PHONE NUMBER

Job Title

DESCRIBE MAJOR DUTIES

REASON FOR LEAVING

First Reference Name

First Reference Telephone number

How do you know the person, and how long have you known them?

Second Reference Name

Second Reference Telephone Number

HOW DO YOU KNOW THE PERSON, AND HOW LONG HAVE YOU KNOWN THEM?

Third Reference Name

Third Reference Telephone Number

HOW DO YOU KNOW THE PERSON, AND HOW LONG HAVE YOU KNOWN THEM?

“By submitting this application I certify that the facts contained in this application are true and complete. I authorize Town & Country to verify the accuracy of the information provided herein, I authorize former employers and educational institutes to provide information concerning me, and I release them from liability for providing any such information to Town & Country. I further authorize Town & Country to provide others information concerning me, and I release Town & Country from liability for providing any such information. I also authorize Town & Country to investigate my criminal convictions and driving record. I understand that falsification, misrepresentation, or omission of requested facts will result in denial of employment or, if employed, will result in immediate dismissal. I understand and agree that, if hired, my employment will be for no definite period and may, regardless of the date of payment of wages, be terminated at any time without previous notice and with or without reason, at the will of either myself or Town & Country. I also understand and agree that no one has the authority to promise me job security or continued employment, except T&C President/Owner in a formal written agreement signed by both of us.”

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