Rushford Lake Recreation District
Employment

Job Application

How to Apply:

 

Rushford Lake Recreation District

8999 Main Street, Rushford, NY 14777

email: rlrdsecretary@yahoo.com

 

 

JOB APPLICATION FORM

 

PERSONAL INFORMATION:

 

Name: ______________________________________________________________________

 

Street Address:            ________________________________________________________

 

City, State, Zip Code: __________________________________________________________

 

Phone Number: ____________________________________________________

 

If you are under 18, do you have an employment/age certificate?    Yes __ No__

 

Have you been convicted of or pleaded no contest to a felony within the last five years?   Yes__  No__

 

Position Applied For: _________________________________________________

 

Days/Hours Available: ______________________________________

Monday _____________

 

Tuesday ___________

 

Wednesday ___________

 

Thursday ____________

 

Friday ____________

 

Saturday ____________

 

Sunday ____________

 

Hours Available: from _______to ______

 

What date are you available to start work? ____________

 

 

Please provide the names and telephone numbers of three references (not relatives):

 

. ___________________________________________________________________

 

 

. ___________________________________________________________________

 

 

. ___________________________________________________________________

 

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any and all information listed above.

 

 

Signature ___________________________________________________

 

 

Date: _____________________________________