Fillable TOWN OF WETHERSFIELD PARKS & RECREATION DEPARTMENT APPLICATION (Town of Wethersfield)

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TOWN OF WETHERSFIELD PARKS & RECREATION DEPARTMENT APPLICATION (Town of Wethersfield)

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TOWN OF WETHERSFIELD PARKS & RECREATION DEPARTMENT
APPLICATION FOR PART-TIME/SEASONAL EMPLOYMENT
Position Applied For _______________________________________ Date of Application ____________________
PERSONAL INFORMATION
Last Name ________________________________ First & Middle Names __________________________________
Street Address _____________________________ City ______________________ State ____ Zip Code _________
Home Phone ______ - ______- ________ Cell Phone ______ - ______- ________
Work Phone ______ - ______- ________ May we call you at work? Yes No
E-Mail Address __________________________________________________________________________________
Driver's License State ____ Number ____________ How did you learn of this position? ________________________
EDUCATION
Name & Location Years Degree Course of Study Dates Attended (MM/YY)
Completed From To
High School _______________________________ ______ _______ _________________ _________ _________
College ___________________________________ ______ _______ _________________ _________ _________
Graduate/Other _____________________________ ______ _______ _________________ _________ _________
EMPLOYMENT HISTORY
(List the last three employers starting with the most recent.)
Employer & Location Job Title Supervisor Phone Dates Employed (MM/YY)
Name & Title Number From To
Job 1 ___________________ _________________ _________________ ____-____-_____ _________ _________
Job 2 ___________________ _________________ _________________ ____-____-_____ _________ _________
Job 3 ___________________ _________________ _________________ ____-____-_____ _________ _________
VOLUNTEER HISTORY
(List any significant volunteer jobs starting with the most recent.)
Organization Volunteer Duties Supervisor Phone Dates (MM/YY)
& Location Name & Title Number From To
Job 1 ___________________ _________________ _________________ ____-____-_____ _________ _________
Job 2 ___________________ _________________ _________________ ____-____-_____ _________ _________
Job 3 ___________________ _________________ _________________ ____-____-_____ _________ _________
REV
03/13
TOWN OF WETHERSFIELD PARKS & RECREATION DEPARTMENT
APPLICATION FOR PART-TIME/SEASONAL EMPLOYMENT
PAGE 2
REFERENCES
(List three non-relatives who know you well, e.g. supervisor, teacher, adult co-worker, neighbor, etc.)
Relationship Years
Name Phone Number Address to Applicant Known
________________________ ____-____-_____ _______________________ _______________________ ________
________________________ ____-____-_____ _______________________ _______________________ ________
________________________ ____-____-_____ _______________________ _______________________ ________
SPECIAL QUALIFICATIONS
(List any special training, certificates, licenses or registrations, e.g. First Aid, commercial driver’s license, etc.)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
CERTIFICATION
I certify that, to the best of my knowledge and belief, all responses on this application are correct and complete. I
understand that all information is subject to investigation and that misleading or false statements may cause my
application to be rejected or may cause my dismissal.
I hereby authorize the Town of Wethersfield Parks and Recreation Department to communicate with my former
employers, school officials and individuals named as references.
Signed __________________________________________________ Date _________________________________
SUBMIT TO
(A cover letter explaining your interest in the position is recommended and a complete resume may be included.)
Wethersfield Parks & Recreation Department
505 Silas Deane Highway
Wethersfield, CT 06109
860-721-2890
Office Use Date Received __________ Forward To ____________________ Notes ___________________________________________
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TOWN OF WETHERSFIELD PARKS & RECREATION DEPARTMENT APPLICATION (Town of Wethersfield)

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Completed 17 July 2020

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