RAC Employment Application

Rockwell Aquatic Center Job Application

Complete the form below to apply for a position at the Rockwell Aquatic Center
Applicant Information
Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Position Applied
Date Available

MonthDayYear
Date
Desired Salary (per hour)
Are you a citizen of the United States?
If no, are you authorized to work in the US?
Have you ever worked for the city before?
If so, when?
Have you ever been convicted of a felony?
If yes, explain:
Education
High School
Did you graduate?
From

MonthDayYear
Date
To

MonthDayYear
Date
College
Did you graduate?
From

MonthDayYear
Date
To

MonthDayYear
Date
Degree/Certificate/Diploma
Other
Did you graduate?
From

MonthDayYear
Date
To

MonthDayYear
Date
Degree/Certificate/Diploma
References

Please list professional references
Name

First NameLast Name
Company
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
- Name
  
  First NameLast Name
- Company
- Relationship
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
- Name
  
  First NameLast Name
- Company
- Relationship
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
- Previous Employment
  
  Please include all pool experience
- Company
- May we contact your previous supervisor for a reference?
- Supervisor
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
- Job Title
- Reason for Leaving
- Starting Salary
- Ending Salary
- From
  
  MonthDayYear
  Date
- TO
  
  MonthDayYear
  Date
- Responsibilities
- Company
- May we contact your previous supervisor for a reference?
- Supervisor
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
- Job Title
- Reason for Leaving
- Starting Salary
- Ending Salary
- From
  
  MonthDayYear
  Date
- TO
  
  MonthDayYear
  Date
- Responsibilities
- Company
- May we contact your previous supervisor for a reference?
- Supervisor
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
- Job Title
- Reason for Leaving
- Starting Salary
- Ending Salary
- From
  
  MonthDayYear
  Date
- TO
  
  MonthDayYear
  Date
- Responsibilities
- Current Relevant Certifications
- Resume/Cover Letter
  
  Cancelof
- Disclaimer and Signature:
  
  I certify that my answers are true and complete to the best of my knowledge.
  If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
  The city of Rockwell is an Equal Opportunity Employer (EOE) and abides by the rules and regulations of the EOE.
- Signature
- Date
  
  MonthDayYear
  Date
- Should be Empty:

Rockwell Aquatic Center Job Application

Applicant Information

Education

References

Previous Employment