Employment Application
Personal Data
Date of Application *
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Last Name *
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First Name *
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Middle Initial
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Address *
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City *
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State *
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Zip *
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Phone *
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E-Mail Address
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Sex *
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Date of Birth *
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YYYY
High School Diploma/GED
Post Secondary Degree
Major
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Minor
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How did you hear about Camp Evergreen?
Your answer
Position/s you're interested in: *
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Work Experience
List most recent work experience first.
Company Name
Your answer
Immediate Supervisor
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Phone
Your answer
Job Title
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Job Description
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Dates: From month/year - To month/year)
Your answer
Reason for Leaving
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Company Name
Your answer
Immediate Supervisor
Your answer
Phone
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Job Title
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Job Description
Your answer
Dates: From month/year - To month/year)
Your answer
Reason for Leaving
Your answer
Company Name
Your answer
Immediate Supervisor
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Phone
Your answer
Job Title
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Job Description
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Dates: From month/year - To month/year)
Your answer
Reason for Leaving
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Would you like to be informed before we contact your current and/or previous employer?
Volunteer Work
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Licenses, Certifications, special skills, etc.
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Personal References
Preferably persons who know about your work/volunteer history.
Name *
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Phone Number *
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Name *
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Phone Number *
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Name *
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Phone Number *
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Have you ever been convicted of a crime, including sex related or child abuse offenses? *
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Signature
With my signature below (typed or written), I certify that all of the information on this and all attached pages is true, correct, and complete to the best of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to release job-related information they may have on file regarding my employment with them and I release all persons or companies from any liability or responsibility for providing such information.
Name *
Your answer
Date *
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