Employment Application

Your Information

Phone*

Email*

Position(s) Applying For*

What date are you available to start?

Are you available to work the hours required for the job (i.e., weekends, nights, holidays, etc.)? If no, please list why.

If yes, specify date & position:

If yes, please note employee’s name and relationship to the individual:

If yes, please explain:

Education

High School/Other:*

Graduation Date:*

College:

Years Attended/Graduation Date:

College:

Years Attended/Graduation Date:

Other Training/Education:

Employment History

Employment (Most Recent):

Employer:

Address:

Phone:

Starting Date:

Ending Date:

Starting Pay:

Ending Pay:

Starting Position:

Ending Position:

Supervisor:

May we contact?

Employment #2:

Employer:

Address:

Phone:

Starting Date:

Ending Date:

Starting Pay:

Ending Pay:

Starting Position:

Ending Position:

Supervisor:

May we contact?

References

Reference #1:

Name:

Phone:

Years Known:

Reference #2:

Name:

Phone:

Years Known:

Additional Information

You may exclude information, which would reveal sex, race, religion, national origin, age, color, disability, sexual orientation, or other protected status.

List past experience and/or qualifications specific to this job

Applicants Statement

I certify that the information provided in this application is true, to the best of my knowledge.

I understand that providing false or misleading information at any time during the application and interview process may lead to refusal to hire or discharge from the Hutchinson Recreation Commission (HRC). If I become employed by HRC, I agree to follow all rules and regulations of HRC as they develop and change.

I allow HRC to conduct investigations on me, my background, and my performance and am aware that such investigations will become a part of my employment record. With this, I authorize HRC to speak with acquaintances, personal and professional, to gather information about me.

I authorize all former employers and references to provide any information about me to HRC and release them of liabilities and damages of all kinds for providing this information. I authorize HRC to verify the accuracy of the information within this application. I also authorize the release of my educational transcripts to HRC for education verification purposes.

I release HRC from liability for collecting information about me and using it to make employment decisions. If I become employed by HRC, I understand that the employment relationship will be “at will” and that the “at-will” status may not change at any time unless specifically approved, in writing, by the Executive Director of HRC.

I agree that if I become indebted to HRC, I will be responsible for repaying the total owed upon termination from the Company. If I do not repay the sum prior to my final paycheck being received, the money owed will be deducted from my pay.

This application for employment is valid for the next 90 days. I understand that if I wish to be considered for employment after this period of time, I must apply again.

Electronic Signature*

Please enter your name to certify the information you provided is correct as a digital signature.