Adult Form
Interested in working at the Boys & Girls Clubs of Northwest Colorado?

All positions pay $14-$16 per hour. Please fill out and submit the following application. The Background Check form found on the website must be completed also to be considered for employment. If you have questions, refer to our website or contact the office using the information listed below.

Kristen Weese
Unit Director Steamboat
P.O. Box 776410 Steamboat Springs, CO 80477
kweese@bgcnwc.org
(970) 871-3166
www.bgcnwc.org
Email address *
Application for Employment
Name *
Last, First, Middle
Your answer
Email *
Your answer
Which Club are you applying for a position with?
Permanent Mailing Address:
This is a permanent address that W-2 tax information or other necessary items can be mailed to you
Your answer
Permanent Mailing Address City
Your answer
Permanent Mailing Address State
Your answer
Permanent Mailing Address Zip Code
Your answer
Current Physical Address
Your answer
Number of years at current address
Your answer
Social Security No. *
Your answer
Phone number (Home)
Your answer
Phone number (Cell) *
Your answer
Days available to work *
Required
How many hours can you work weekly?
Your answer
Can you work evenings?
Your answer
Employment Desired:
When are you available to start?
MM
/
DD
/
YYYY
Will this be a second job?
If yes, what is the name of other employer?
Your answer
Have you ever been convicted of a crime?
If yes,
Explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation.
Your answer
Did you graduate from High School?
Name, location, number of years
Your answer
Did you attend/graduate College?
Name, location, number of years, major and degree
Your answer
Did you attend a Bus. or Trade School?
Name, location, number of years, major and degree
Your answer
Do you have a Drivers License?
Proof of Automobile Insurance will be required as a condition of employment
Driver's License Number
Your answer
State of Issue
Your answer
Expiration Date
Your answer
Have you had any accident during the past three years?
Your answer
How many?
Your answer
Have you had any moving violations during the past three years?
Your answer
How many?
Your answer
Have you ever been in the Armed Forces?
Are you now a member of the National Guard
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