Eastern Wyoming College
APPLICATION FOR EMPLOYMENT
3200 West C Street Torrington, WY 82240 MAINTENANCE AND GROUNDS APPLICATION
Eastern Wyoming College is committed to providing equal opportunity for access to and participation in college programs of instruction, services, and activities. It is the policy
of the college to neither favor nor disfavor any individual on the basis of race, color, creed, religion, sex, disability, or national origin. The college is subject to and complies with
the regulations of Title VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, and Section 504 of the Rehabilitation Act of 1973 and Americans with
Disabilities Act. Inquiries regarding compliance may be directed to the Director of Human Resources, Eastern Wyoming College, Torrington, WY, 82240 or phone (307) 532-
8330, or the Wyoming Department of Education, Office for Civil Rights Coordinator, 2nd Floor, Hathaway Building, Cheyenne, WY 82002-0050, or (307) 777-6218.
Date __________________________________________________
Name___________________________________________________________________
(Last) (First) (Middle)
Telephone _____________________________________________
U.S. Citizen Yes __ No ________
If not, VISA Class _________________________________________________________
Student _________ Non Student ___________________
For what kind of position are you applying? ____________________________________
________________________________________________________________________
Other work you would consider:
1. ____________________________________________________
2._____________________________________________________
3. _____________________________________________________
Have you ever been convicted of a misdemeanor or felony? _________________
Explain:
________________________________________________________________________
________________________________________________________________________
Address _________________________________________________________________
________________________________________________________________________
Name and address of person to be notified in case of emergency.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Can you accept position immediately? _____________________
If not, how soon? ______________________________________
Have you ever worked at EWC before? _____________________
When? ____________ Department _____________________________
Reason for leaving? ________________________________________________________
Have you ever been suspended or discharged from a position? _____________________
Reason:
________________________________________________________________________
________________________________________________________________________
EDUCATION
High School:_____________________________________________________________
Business College: _________________________________________________________
Location:________________________________________________________________
Location:________________________________________________________________
Years Completed: _________________________________________________________
Years Completed:_________________________________________________________
Did You Graduate? Yes __________ No __________
Did You Graduate? Yes __________ No __________
College or University: __________________________________________________________
Special Training: ___________________________________________
Location:_____________________________________________________________________
Location: _________________________________________________
Years Completed: ______________________________________________________________
Years Completed:___________________________________________
Major ________________________________ Minor ________________________________
Major ________________________________ Minor ________________________________
Did you Graduate? Yes __________ No __________
Did you Graduate? Yes __________ No __________
EMPLOYMENT HISTORY Begin with most recent or current employment. May we contact your current employer? Yes ________ No _________
Employer:
Employer:
Employer:
Address:
Address:
Address:
Supervisor:
Supervisor:
Supervisor:
Type of Position:
Type of Position:
Type of Position:
Starting Date:
Starting Date:
Starting Date:
Ending Date:
Ending Date:
Ending Date:
Reason for Leaving:
Reason for Leaving:
Reason for Leaving:
Salary:
Salary:
Salary:
REFERENCES May be personal or professional references (do not use family members/relatives or the Supervisors listed above).
Name:
Name:
Name:
Address:
Address:
Address:
Phone:
Phone:
Phone:
Profession or Occupation of Reference:
Profession or Occupation of Reference:
Profession or Occupation of Reference:
Please check the following with which you have had experience or training:
___Tractor w/Snow blower or Mower ___Hand tools ___Burnisher
___Vacuum Cleaner ___Scrubber ___Shampooer
___Weed Eater ___Riding Lawn Mower ___Push Mower
___Dump Truck ___Fork Lift
Please check if you have had experience with the following:
Maintenance & Repair of:
___Carpentry ___Air Conditioning ___Gas Vehicles
___Plumbing ___Boilers and Controls ___Diesel Vehicles
___Electricity ___Cleaning Chemicals
___Welding ___Driving a Bus? Do you possess a valid license? Yes __________ No __________
Are you willing to work on tall ladders, a lift or scaffolding? Yes __________ No _________
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
I certify that all information given on this application, supporting documents, and interviews is correct to the best of my knowledge. I understand that giving false information is
cause for dismissal and that a physical examination (post conditional offer) may be required. I understand that this application is not intended to be a contract of employment. I
agree that Eastern Wyoming College may require my participation in a contribution to retirement plans while employed. I further authorize Eastern Wyoming College to
investigate all statements made on my application for employment. I authorize such educational institutions and employers and others (and their agents or employees) to respond
to questions concerning information given on this application and I further release from liability such former employers, institutions, or person providing such information to
Eastern Wyoming College. I understand that no offer of benefits such as insurance, vacation or salary rate is final until approved by the Director of Human Resources. I
understand that I will be required to complete an I-9 form for income tax purposes. I understand that I will be required to serve a probationary period during which time I may
be terminated in accordance with Eastern Wyoming College policy.
Signature Date_____________________________
click to sign
signature
click to edit