Fillable EMPLOYMENT APPLICATION

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EMPLOYMENT APPLICATION

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File type: PDF

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Instructions: Answer all questions in blue or black ink or
in typed format. When completing this application, show as clearly as
possible that you meet each of the specific requirements listed in the job description. False statements or failure to provide
complete information is cause for rejection of application, reduced rating, removal of name from eligibility list, and/or dismissal from
position. Answer questions as completely as space will permit, attaching additional sheets as needed.
EXACT TITLE OF POSITION APPLYING FOR: ___________________________________________________________________
NAME:_____________________________________ _____________________________________ _________________________
LAST FIRST MI
MAILING ADDRESS:________________________________ ______________________________________________________
NUMBER STREET
CONTACT PHONE:____________________
CITY STATE ZIP CODE
EMAIL:_______________________________________________________________ SECONDARY PHONE: ___________________
CA DRIVER'S LICENSE NUMBER: _____________________________________ EXPIRATION DATE: _________________
Are you 18 or older?
Are you related to any employee(s) of the Hesperia Recreation and Park District?
If Yes, Name of Relative: _______________________________________________ Relationship: ____________________________
Have you applied for this position before? If Yes, when? _________________________________________________
Have you ever worked for the District? If Yes, when? ____________________________________________________
EDUCATION
Do you have a High School Diploma or a G.E.D certificate? If NO, circle highest grade completed: 7 8 9 10 11 12
Name and Location of High School: _____________________________________________________________________________
HR USE ONLY
☐
Application Accepted
☐
Application Rejected
Reason(s) for Rejection:
☐Experience deficient and/or not competitive ☐Late Application
☐Education deficient and/or not competitive ☐Incomplete Application
Reviewed by: __________________________________________________
Notes:
Interview:
☐
Yes
☐
No Date:_____________________ Time:_________
Notes:
HESPERIA RECREATION & PARK DISTRICT
P.O. Box 401055, Hesperia, CA 92340-1055 760-244-5488
EMPLOYMENT APPLICATION
College, Business, or Trade School attended:
Major:
Units/Type
Completed:
Degree:
Professional Licenses or Certificates and issue date (attach a separate sheet if necessary):
Do you speak any language in addition
to English? ☐Yes ☐No Specify:
Revised: 2020-03-12
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
___________________________________ ___________ _______
EXPERIENCE: List your last four (4) jobs, including relevant volunteer experience. IN ADDITION, list any earlier experience of any
kind required for this position. If additional space is needed, attach a sheet of paper prepared in the same format. A resume is not required.
If you elect to attach a resume or additional documentation, please indicate such attachments:
From (Month & Year)
Job Title
Company Name
Phone
To (Month & Year)
Description of Duties
Number and Street
City
State
Hours Worked Per
Week
Supervisor Name & Title
May we contact this
employer? ☐YES
☐
NO
Reason for Leaving or Wanting to Leave
From (Month & Year)
Job Title
Company Name
Phone
To (Month & Year)
Description of Duties
Number and Street
City
State
Hours Worked Per
Week
Supervisor Name & Title
May we contact this
employer? ☐YES
☐
NO
Reason for Leaving
From (Month & Year)
Job Title
Company Name
Phone
To (Month & Year)
Description of Duties
Number and Street
City
State
Hours Worked Per
Week
Supervisor Name & Title
May we contact this
employer? ☐YES
☐NO
Reason for Leaving
From (Month & Year)
Job Title
Company Name
Phone
To (Month & Year)
Description of Duties
Number and Street
City
State
Hours Worked Per
Week
Supervisor Name & Title
May we contact this
employer? ☐YES
☐
NO
Reason for Leaving
I certify
that I have read and meet the specific requirements listed on the job description for this position. I understand that I may be requested
to submit proof of qualification at a later date. If upon checking these, you determine that I do not meet specific requirements, I understand that I
will be d
isqualified.
I declare under penalty of perjury that all answers and statements in this application (and attachments if applicable) are true and complete to the best
o
f my knowledge and belief. I understand that untruthfulness or misleading answers on this application (and attachments if applicable), or
during any portion of the interview process are cause for rejection of this application, removal from an eligibility list, or dismissal from District
employment.
I
un
derstand that the District may wish to verify the accuracy of the information contained in my application (and attachments if applicable). If I
am a finalist for this position, I hereby authorize the District to obtain information which may concern me regarding my references, education or
training, prior employ
ment and criminal history, including driving record. I understand the District has a right to obtain any criminal history
information. All candidates offered a position must be fingerprinted and cleared before starting work.
Da
te:
Applicant Signature:
Hesperia Recreation and Park District is an Equal Opportunity Employer.
Revised: 2020-03-12
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EMPLOYMENT APPLICATION

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Completed 30 September 2020

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