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*
Position Applied*
Date Available*

MonthDayYear
Date
Desired Salary (per hour)*
Are you a citizen of the United States?*

YesNo
If no, are you authorized to work in the US?*

YesNo
Have you ever worked for the city before?*

YesNo
If so, when?*
Have you ever been convicted of a felony?*

YesNo
If yes, explain:*
Education
High School
Did you graduate?

YesNo
From

MonthDayYear
Date
To

MonthDayYear
Date
College
Did you graduate?

YesNo
From

MonthDayYear
Date
To

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

YesNo
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.
Email

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*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Rockwell Aquatic Center Job Application