Kids Klub Job Application Name Mailing Address City, State, and Zip Code Home Phone Cell Phone E-mail Address May we use e-mail to contact you? Yes No What position are you applying for? Additional Information **These questions must be answered in order to be considered for employment.** ***The Cañon City Area Metropolitan Recreation & Park District is a state licensed childcare provider.*** Have you been an employee of this organization in the past? Yes No Are you related to anyone in our organization? Yes No If yes, please give their name, relation, and position. I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.** Yes No Have you ever been convicted of, or entered a plea of guilty, no contest, or had a withheld judgment to a felony?*** Yes No If Yes, please explain: What date can you start? Salary Per: Education (Schools attended or special training received- List current or most resent first) School Location Did you graduate? Type of degree or diploma School Location Did you graduate? Type of degree or diploma School Location Did you graduate? Type of degree or diploma Work History (List present or most recent job first) Job Title From To Hrs./Week Employer Address Phone Supervisor May we contact this employer? Yes No Job Title From To Hrs./Week Employer Address Phone Supervisor May we contact this employer? Yes No Job Title From To Hrs./Week Employer Address Phone Supervisor May we contact this employer? Yes No How did you find out about this position? Current Employee Newspaper Ad Radio/TV Ad Other Internet Source Prof. Organization website Job Service None of the Above Job Shift/Type Full Time Part Time Permanent Temporary 6 Month 9 Month Seasonal References - Give the name of 3 persons not related to you whom you have known at least 1 year Reference Name (1) Occupation Address Phone Number Reference Name (2) Occupation Address Phone Number Reference Name (3) Occupation Address Phone Number Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures Cañon City Area Metropolitan Recreation and Park District Job Application Agreement and Certification Read Before Signing “I certify that the information given by me in this application is true and complete in all respects, and I agree that if the information given is found to be false in any way, employment may be denied or I may be discharged. I authorize the use of any information in this application to verify my statements, and I authorize my past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I release all such persons from all liability or damages on account of having furnished such information.” “I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Cañon City Area Metropolitan Recreation and Park District and myself for either employment or the providing of any benefit. No promises regarding employment or regarding the way in which I will be treated if I am employed have been made to me, and I understand that no such promise, covenant or guarantee is binding upon Cañon City Area Metropolitan Recreation and Park District unless made in writing. If an employment relationship is established, I understand that I have the right during the introductory period of if I am ever placed on disciplinary probation.” “I understand that prior to being offered employment with Cañon City Area Metropolitan Recreation and Park District, I may be requested to take an employment examination. In the event I have a disability, which will affect my ability to take the test, I will so inform Cañon City Area Metropolitan Recreation and Park District, prior to the administration of the test so that a reasonable accommodation can be made. Requested accommodations may include accessible testing sites and modified testing formats. Cañon City Area Metropolitan Recreation and Park District reserves the right to require medical documentation concerning the need for the accommodation.” “I understand that if employed, policies and rules which are issued from time to time by Cañon City Area Metropolitan Recreation and Park District are not conditions or employment and that the employer may revise policies or procedures, in whole or in part, at any time, and with or without prior notice.” “I agree that if I ever feel that I am treated unfairly or discriminated against in any way during my employment, that I will immediately inform my supervisor, or the Executive Director, if the problem is with my supervisor.” “I understand that this application will be kept on active file for 30 days from the date completed, after which time I would have to reapply to be considered for this or any other position by Cañon City Area Metropolitan Recreation and Park District.” I HAVE READ AND AGREED TO THE ABOVE Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures There was a problem saving your submission. 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