Rushford Lake Recreation District

Job Application

How to Apply:


Rushford Lake Recreation District

8999 Main Street, Rushford, NY 14777








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: _____________________________________