Fulltime Employment Form

Employment is open to all qualified applicants without regard to race, color, sex, age, religion, national origin or disability.

JOB INTEREST

Position Title:

PERSONAL DATA
Last Name:
First/Middle Name:
Street/Apt. #:
City:
State:
Zip Code:
Daytime Phone:
Social Security:
Email Address:
Salary Requirement:


When can you start work?

Are you eligible to be employed in the U.S.?

Do you possess a valid driver's license? If so, what state?

Have you ever been employed by NVRPA? If yes, please provide dates.

List any relatives currently employed by the Park Authority.

Have you ever been convicted of a crime? If yes, please provide dates, details.

When are you available for an interview?

REFERENCES

Please list names, addresses and telephone numbers of two persons, not related to you, have knowledge of your character, experience and abilities:
Reference 1:
Reference 2:


EDUCATION
HIGH SCHOOL
School Name
City/State
Date of Graduation
COLLEGE
School Name
City/State
Date of Graduation
Major
Type of Degree
BUSINESS/TRADE SHCOOL
School Name
City/State
Courses
Date of Completion

List relevant courses or formal education you have completed
List relevant, special skills you possess, machines or equipment you can operate and/or trade licenses you have earned
List relevant, professional organizations or certifications
JOB HISTORY
Provide ALL information requested below, beginning with your current or most recent employer.
   
Employer #1 Name
Work Dates From To
Address
Supervisor
Phone
Pay Rate
Position
Duties
Reason for leaving
May we contact this employer?
Employer #2 Name
Work Dates From To
Address
Supervisor
Phone
Pay Rate
Position
Duties
Reason for leaving
May we contact this employer?
Employer #3 Name
Work Dates From To
Address
Supervisor
Phone
Pay Rate
Position
Duties
Reason for leaving
May we contact this employer?
Today's Date


By submitting this form I hereby certify that every statement I have made in this application is true and complete to the best of my knowledge. I understand that any false or incomplete statement I have made may result in my forfeiting all rights of employment with the Northern Virginia Regional Park Authority. I authorize the Park Authority to obtain all information to support and/or verify the information contained in this application.