Employment Application Please fill out completely. Please enable JavaScript in your browser to complete this form.Date *Name *FirstMiddleLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome Phone *Cell Phone *Email *Date Available *Position you are applying for *Are you a citizen of the United States? *YESNOAre you authorized to work in the U.S.? *YESNOHave you ever worked for the SDRC? *YESNOWhen have you worked for the South Davis Recreation Center? *Have you ever been discharged or forced to resign from a position? *YESNOPlease explain fully. *Have you ever been convicted of violating any Criminal Law other than Minor Traffic Offenses? *YESNOPlease explain fully. *EDUCATIONHigh School *Address *Years you attended High School *Did you graduate? *YESNOWhen will you graduate? *CollegeAddressYears you attended CollegeDid you graduate College? *YESNOWhen will you graduate College? *Other EducationPROFESSIONAL LICENSES OR CERTIFICATIONSDo you have any professional licenses or certifications? *YESNO1. Certificate TitleNumberIssuing AgencyExpiration Date2. Certificate TitleNumberIssuing AgencyExpiration Date3. Certificate TitleNumberIssuing AgencyExpiration DateREFERENCES1. Full Name of Reference *Relationship *Company *Phone *Address *2. Full Name of Reference *Relationship *Company *Phone *Address *PREVIOUS EMPLOYMENT1. CompanySupervisorPhoneAddressJob TitleStarting SalaryEnding SalaryPlease list ALL responsibilitiesStarting DateEnding DateReason for leavingMay we contact your previous Supervisor for a reference? *YESNO2. CompanySupervisorPhoneAddressJob TitleStarting SalaryEnding SalaryPlease list ALL responsibilitiesStarting DateEnding DateReason for leavingMay we contact your previous Supervisor for a reference?YESNOMILITARY SERVICEHave you served in the Military? *YESNOBranchStarting DateEnding DateRank at DischargeType of DischargeIf other than honorable, please explainDisclaimer and Signature *I authorize investigation of all statements contained in this application, and a check of my criminal history, traffic record, previous employment and educational background. I release South Davis Recreation District and providers of information from any liability as a result of furnishing and receiving any information in this hiring process. I understand that I will be required to submit to a pre-employment drug test as a condition of employment. I certify that all information provided by me in connection with this application is true and complete, and understand that misrepresentation or omission of facts in this application is cause for disqualification of the application and/or separation from employment.Submit