Coach Derek, Inc. Online Forms Employment Form | CDI Inc. Please use the form below to to fill out your application. Your Name, First and Last (required) Your Email (required) Referred by: Position Applying For: Home Phone: Cell Phone: What days and hours are you available: Current Address, Number and Street: City, State and Zip Code: If hired, would you have transportation to/from work? YesNo Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age.) YesNo If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States? YesNo Have you ever been convicted of a criminal offense (felony or misdemeanor)? YesNo If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case. (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.) Education, Training and Experience High School High School Name: High School City and State: Did you graduate? YesNo High School Degree/Diploma Earned: College College Name: College City and State: Did you graduate? YesNo College Degree/Diploma Earned: Vocational School Vocational School Name: Vocational School City and State: Did you graduate? YesNo Vocational School Degree/Diploma Earned: Additional Information Do you speak, write or understand any foreign languages? YesNo If yes, describe which languages(s) and how fluent of a speaker you consider yourself to be. Do you have any other experience, training, qualifications, or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us? YesNo If yes, please explain: Why would you like a Coaching Position with our Company? By hitting the submit button you are confirming that all information entered above is true and accurate.