Employment Application

Date of Application (required)

First Name (required)

Last Name (required)

Address Line 1 (required)

City (required)

State (required)

Zip Code (required)

Home Phone (required)

Cell Phone (required)

Email (required)

Are you a citizen of the United States? (required)

Yes

Have you ever worked for the SDRC? (required)

Yes

Have you ever been discharged or forced to resign from a position? (required)

Yes

Have you ever been convicted of violating any Criminal Law other than Minor Traffic Offenses? (required)

Yes

Education

Highschool (required)

Address (required)

Did you graduate?

Yes

College

Address

Years you attended College

Did you graduate College?

Yes

Other Education

If you were referred to apply for your chosen position by a current employee, please list their name here.

Professional Licenses or Certifications

Do you have any professional licenses or certifications? (required)

Yes

References

1. Full Name of Reference

Relationship

Company

Phone

Address

2. Full Name of Reference

Relationship

Company

Phone

Address

Previous Employment

1. Company

Supervisor

Phone

Location

Job Title

Starting Salary

Ending Salary

Please list ALL responsibilities

Starting Date

Ending Date

Reason for leaving

May we contact your previous Supervisor for a reference?

Yes

2. Company

Supervisor

Phone

Location

Job Title

Starting Salary

Ending Salary

Please list ALL responsibilities

Starting Date

Ending Date

Reason for leaving

May we contact your previous Supervisor for a reference?

Yes

Military Service

Have you served in the Military?

Yes

Disclaimer and Signature (required)

I authorize investigation of all statements contained in this application, and a check of my criminal history, traffic record, previous employment and educational background. I release South Davis Recreation District and providers of information from any liability as a result of furnishing and receiving any information in this hiring process. I understand that I will be required to submit to a pre-employment drug test as a condition of employment. I certify that all information provided by me in connection with this application is true and complete, and understand that misrepresentation or omission of facts in this application is cause for disqualification of the application and/or separation from employment.

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