**Please mail in your job application. Faxes are often too hard to read!
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Employment Application (print neatly) NAME__________________________________ S.S.#_________________________ PERMANENT MAILING ADDRESS __________________________________________ CITY _________________________ STATE _______ ZIP CODE _________________ HOME PHONE_____________________ CELL PHONE ________________________ PHYSICAL: Do you now have or have you ever had, within the last six months, any contagious or communicable diseases, or gastro-intestinal infections, or have you ever had hepatitis or salmonella? YES _______ NO _____ If yes, explain _______________________________ What training or experiences have you had and what qualities do you possess that will create a more positive experience for our campers?____________________________________________________________________ _____________________________________________________________________ DRIVERS LICENSE #______________________________________ STATE _______ JOB APPLIED FOR________________________________________ YOUR AVAILABILITY: Camp starts May 30, 2010 and ends September 4th, 2010. STARTING DATE_______________________ ENDING DATE _________________ WHICH YEAR(S) WERE YOU A CAMPER? ________________ NAME___________________________________ LOCATION______________________ LAST GRADE COMPLETED______________________ G.P.A.____________________ TWO MOST RECENT JOBS: or references COMPANY_______________________________LOCATION________________________ POSITION____________________________ PHONE __________________________ SUPERVISOR_________________________ DATES WORKED: FROM_________ TO ___________ REASON FOR LEAVING___________________________________ SALARY_________ COMPANY______________________________LOCATION________________________ POSITION____________________________ PHONE __________________________ SUPERVISOR_________________________ DATES WORKED: FROM_________ TO ___________ REASON FOR LEAVING___________________________________ SALARY_________ Are you Certified Lifeguard? (circle) YES NO Do you have a current Red Cross First Aid Card? (circle) YES NO What training or experiences have you had and what qualities do you possess that will create a more positive experience for our campers?____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ If you are applying for a Counselor position, I understand that as a vehicle driver, I may be subject to random drug testing. Signature _____________________________ Date___________ I certify that the information in this application is correct to the best of my knowledge and understand that deliberate falsification of this information is grounds for dismissal in accordance with the policy of MHSSC. I authorize the references listed on the other side of this application to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise and release all parties from liability for any damage that may result from furnishing same to you. I acknowledge that, if I become employed, I will be free to terminate at any time for any reason and MHSSC retains the same rights.
Date___________________________ Signature___________________________________ If you are applying for a "camper/staff" or "camper/digger" positions, please fill out and send in both the employment application and camp application forms. |