APPLICATION FOR EMPLOYMENT

Star Valley Ranch Association (307) 883-2669

Applicant must complete all information requested and sign the application. Please print.

Today's Date

Date

Last Name

First Name

Middle Initial

Present Street Address

City

State

Zip

Telephone

Referred by

Position Applying For:

Are you sixteen years of age or older? (Subject to verification upon hire)

YesNo

Do you have the legal right to work in the U.S.?

YesNo

What is your approximate hourly wage requirement?

Type of employment seekeing:

Full TimePart TimeSummer Only

What days are you available for work?

When will you be available to begin employment?

Have you worked for this company before?

YesNo

If yes, please indicate your previous start date:

If yes, please indicate your previous end date:

Previous Position Held:

Reason for leaving previous position:

Name of your High School:

Highest Year of High School Completed:

9101112

Name of your College:

Highest Year of College Completed

1234

Name of Other Schooling:

Highest Year of Other Schooling Completed:

1234

List two references that have knowledge of your qualifications for the position for which you are applying. Do not list family members or relatives.

Name

Address

Telephone

Years known

Relationship

Name

Address

Telephone

Years Known:

Relationship:

List present and past employment beginning with most recent. Attach resume or extra pages if needed to provide additional information.

1. Company Name

Start date of Employment:

Final date of Employment:

Address

Telephone

Position Held

Supervisor

Starting Wage

Present or Final Wage

May we contact this employer?

YesNo

Reason for Leaving

Duties/Responsibilities

2. Company Name

Start date of employment:

Final date of employment:

Address

Telephone

Position Held

Supervisor

Starting Wage

Present or Final Wage

May we contact this employer?

YesNo

Reason for Leaving

Duties/Responsibilities

3. Company Name

Start date of employment:

Final date of employment:

Address

Telephone

Position Held

Supervisor

Starting Wage

Present or Final Wage

May we contact this employer?

YesNo

Reason for Leaving

Duties/Responsibilities

I certify that I have read and understood all of this employment application. It is agreed and understood that the employer or its agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or not. and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with this company. I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job.

I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason.

I agree to furnish such additional information as may be required to complete my employment file.

I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal.

If hired, I agree to abide by all the rules and policies of the employer.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Signature

Date

If applicable, please attach your resume or additional information you wish to be considered.

APPLICATION FOR EMPLOYMENT

COMPANY EXPERIENCE

EDUCATIONAL BACKGROUND

WORK REFERENCES

Employment History

APPLICANT MUST READ AND SIGN