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Employment
Dedham Country and Polo Club (DCPC) is one of the oldest country clubs in Massachusetts. As a premier family club, we offer a variety of social and athletic programs to our members.
If you are interested in something more than a job and want to be a part of a warm and friendly community that values hard work and camaraderie, we invite you to apply.
Attention: Please note you will have 45 minutes to complete this form or be timed out
Applications are considered without regard to race, color, religion, sex, protected sexual orientation, marital status, veteran's status, national origin, ancestry, age, genetic information, or handicap. Also it is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Date:
Position (s) applied for:
Referral Source:
Walk in
Print Ad
Other
If Other, please explain:
Member Referral:
Employee Referral:
Last Name:
First Name:
Middle Name:
Address Number:
Street:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
DC
INTL
Zip Code:
Phone:
Email:
Social Security #:
License #:
Have you been employed at the Dedham Country and Polo Club before?
Yes
No
If Yes, please indicate dates and position:
If you are employed and under 18, can you furnish a work permit?
Yes
No
For security, grounds, or maintenance position, please indicate if you have a valid driver's license and provide the # above.
Yes
No
Are you over 18?
Yes
No
Are you employed now?
Yes
No
May we contact your present employ?
Yes
No
Do you have a legal right to work in the United States?
Yes
No
According to Federal Law, work authorization documentation will be required upon employment.
On what date would you be available for work?
Are you available to work:
Full Time
Part Time
Seasonal
Other
Are you on a lay-off and subject to recall?
Yes
No
Employment Experience
Start with your present or last job. Include military service assignment and any verified work performed on a volunteer basis. Exclude organization names which indicate race, color, religion, sex or national origin.
Employer:
Address:
Phone:
Supervisor:
Reason for leaving?
Dates of Employment
From:
To:
Hour Rate/Salary:
May we contact?
Yes
No
Job Title:
Duties:
Employer:
Address:
Phone:
Supervisor:
Reason for leaving?
Dates of Employment
From:
To:
Hourly Rate/Salary:
May we contact?
Yes
No
Job Title:
Duties:
Employer:
Address:
Phone:
Supervisor:
Reason for leaving?
Dates of Employment
From:
To:
Hourly Rate/Salary:
May we contact?
Yes
No
Job Title:
Duties:
Employer:
Address:
Phone:
Supervisor:
Reason for leaving?
Dates of Employment
From:
To:
Hourly Rate/Salary:
May we contact?
Yes
No
Job Title:
Duties:
Employer:
Address:
Phone:
Supervisor:
Reason for leaving?
Dates of Employment
From:
To:
Hourly Rate/Salary
May we contact?
Yes
No
Job Title:
Duties:
Veteran of the U.S. Military service?
Yes
No
Please describe any special skills or training acquired while in the service:
Availability
What hours are you available? Please indicate your total availability below:
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Total Hours:
What day/times are you NOT availble to work?
Language Skills
Optional Question - Please indicate what language other than English you speak, read, and/or write. Knowledge of a foreign language can be helpful in communicating with guests and employees at the Dedham Country and Polo Club. Please also indicate your competency with the language (Fluent, Good or Fair).
Speak:
Read:
Write:
Special Skills and Qualifications that would be useful in the position (s) you are applying for:
Education
Name of Elementary School:
Years Completed:
4
5
6
7
8
Honors Received:
Name of High School:
Years Completed:
9
10
11
12
Honors Received:
Name of College/University:
Years Completed:
1
2
3
4
Diploma/Degree:
Describe Course of Study:
Honors Received:
Name of Graduate/Professional School
Years Completed:
1
2
3
4
Diploma/Degree
Describe Course of Study:
Honors Received:
Please describe Specialized Training Apprenticeship, Skill and Extra - Curricular Activities:
References
List three names, addresses, and telephone numbers for the people who are not related to you and who you know your work style and experience.
Name:
Phone:
Relationship:
Years Known:
Company Affiliation:
Name:
Phone:
Relationship:
Years Known:
Company Affiliation:
Name:
Phone:
Relationship:
Years Known:
Company Affiliation:
It is my understanding that this employment application, or the granting of an interview, does not represent a contract of employment or a promise of future benefits by the Dedham Country and Polo Club. I understand and agree that if hired, my employment will be at-will in nature and may be terminated, with or without cause, at any time, by either myself or my employer. I also understand that this written statement supersedes any and all oral representations made by agents or representatives of the Dedham Country and Polo Club.
AGREEMENT:
I certify that the information on this application is true and correct. I authorize the Dedham Country and Polo Club to investigate my past employment, education and activities and I understand that false answers, statements or significant omissions made by me on this form shall be sufficient cause for denial of employment or discharge.
Signature of Applicant:
Date:
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