Maintenance Employment Application

2601 E Sunnyside Avenue, Salt Lake City, Utah 84108

801-582-1847/Fax 801-583-1869

Maintenance Employment Application Form

Today's Date*

Date

Contact Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Email*

Are you age 16 or older?*

YesNo

What is your level of completed education?*

Do you have transportation to work?*

YesNo

Have you ever been convicted of a misdemeanor (other than minor traffic) or a felony that has not been erased from your record?*

YesNo

If yes, explain:

Do you have any relatives employed by This Is The Place Foundation*

YesNo

If yes, identify:

Do you have experience working with people?*

YesNo

If yes, in what way?

Do you have any health problems or physical restrictions that might keep you from doing the necessary tasks of employment?*

YesNo

If yes, what?

Do you speak a foreign language?*

YesNo

If yes, which one(s)?

Have you been trained in First Aid and/or CPR?*

YesNo

References

	Name	Address	Phone Number	Relationship
1.
2.
3.
4.

POSITIONS NOW AVAILABLE - Please check any positions you are interested in.

Part-Time Custodian and Event Liaison - Custodial work, event set up and take down. 20 hours per week, including weekends. Mornings or evenings preferred.Part-Time Garden Maintenance - Watering, planting flowers, yardwork, mowing lawnsPart-Time Maintenance - Various maintenance duties, mowing lawns, construction projects

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How did you hear about us?

PLEASE READ CAREFULLY BEFORE SUBMITTING:

I understand that completion of this application does not indicate that there are any positions open and does not in any way obligate This Is The Place Foundation. It is understood and agreed that any misrepresentations by me in this application will be sufficient cause for the cancellation of the application and/or for separation from This Is The Place Foundation's service if I have been employed.

I understand that, if employed, I may be required to work evenings, holidays and weekends.

I agree, if employed, to abide by all of This Is The Place Foundation's policies and regulations. I understand that This Is The Place Foundation/This Is The Place Heritage Park is a non-smoking, drug and alcohol-free workplace. Any smoking (except for permitted areas, such as the parking lot) or use of alcohol or illegal drugs on the premises is grounds for immediate dismissal.

I authorize This Is The Place Foundation to investigate information regarding my previous employment, my working ability, my character and reputation, and all statements contained in the application, including third party background checks, if deemed necessary. I hereby release This Is The Place Foundation, its officers, employees, representatives, or agents, and the person(s) This Is The Place Foundation contacts in its investigation from any and all liability and/or damage incurred from obtaining or providing such information.

By submmitting this application you are agreeing to the above.

Please verify that you are human*

This Is The Place Heritage Park Maintenance Employment Application