Special Recreation Services Employment Application

Employment Application:

If you have already submitted an application within the past 6 months, you DO NOT have to re-apply. Please email hr@specialrecreationservices.org to let administration know that you are still interested. If something on this application does not pertain to you, please put N/A
Personal Information:
Full Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
County
(Monroe, Pike, Carbon, etc)
Township/ Borough in which you pay local taxes
(For example you live in Tannersville but your township is Pocono)
Phone Number

Area CodePhone Number
E-mail
Where did you see our job advertisement?

Other
Are You a U.S. Citizen?
Are You legally eligible to work in the U.S?
Are You a U.S. Veteran?
If selected for a second interview you submit to a preliminary docket check. If selected for employment are you willing to submit to a background check and a drug test?
Do you understand that you need a vehicle with current inspection/car insurance/ registration
Employment Desired:
Position applying for:
Position Applying for:
Geographic area you prefer (this is for DSP applicants only):

Other
Date You Can Start

MonthDayYear
Hourly Salary Desired
Employment desired?
Education:
High School
Name of High School Attended
High School Address (City and State)
Graduated?
College
Name of College/University Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Trade School/Other
Name of Trade/Technical/Other School Attended
Number of Years Attended
Graduated?
Area of Study/Degree
Skills/Qualifications:
Skills
List any relevant skills
Please list any languages you speak besides English. Please include if you are trained in Sign Language.
List any relevant skills
Qualifications
List any relevant certifications or qualifications
Current Employment:

If you have not been employed recently, please list any recent volunteer experience. If you have past experience working with ADULTS with Intellectual Disabilities/Autism, please list that experience even if it is not recent.
Current Employer/Most Recent Employer
Name of Current Employer or NONE if not Employed
Position
Job duties
Reason for Leaving?
Start Date

MonthDayYear
May We Contact?
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Supervisor's Name
Supervisor's Phone Number

Area CodePhone Number
Previous Employment:
Previous Employer
Name of Previous Employer
Position
Job Duties
Reason for Leaving?
Start Date

MonthDayYear
End Date

MonthDayYear
Supervisor's Name
Phone Number

Area CodePhone Number
References:

Do NOT include relatives or anyone that lives with you.
Reference 1
Name of Reference
Relationship
Occupation of Reference 1
Name of Reference
Years Acquainted
Phone Number

Area CodePhone Number
Email
To send them a reference form to fill out
Reference 2
Name of Reference
Relationship
Occupation of Reference 2
Name of Reference
Years Acquainted
Phone Number

Area CodePhone Number
Email
To send them a reference form to fill out
Reference 3
Name of Reference
Relationship
Occupation of Reference 3
Name of Reference
Years Acquainted
Phone Number

Area CodePhone Number
Email
To send them a reference form to fill out
Cover Letter & Resume (Optional):
Cover Letter

Upload a File

Cancelof
Resume

Upload a File

Cancelof
Send Application:
Please read and electronically sign below: The information I have provided above is correct and truthful to the best of my knowledge. I understand that any false statements provided by me to Special Recreation Services in this application or interview could result in non-hiring or termination of my position. I also understand that filling out this application does not guarantee a position with Special Recreation Services.
Signature
Should be Empty:

Employment Application:

Personal Information:

Employment Desired:

Education:

Skills/Qualifications:

Current Employment:

Previous Employment:

References:

Cover Letter & Resume (Optional):

Send Application: