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
Email *
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
Permanent Mailing Address City
Permanent Mailing Address State
Permanent Mailing Address Zip Code
Current Physical Address
Number of years at current address
Social Security No. *
Phone number (Home)
Phone number (Cell) *
Days available to work *
Required
How many hours can you work weekly?
Can you work evenings?
Employment Desired:
Clear selection
When are you available to start?
MM
/
DD
/
YYYY
Will this be a second job?
Clear selection
If yes, what is the name of other employer?
Have you ever been convicted of a crime?
Clear selection
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.
Did you graduate from High School?
Clear selection
Name, location, number of years
Did you attend/graduate College?
Clear selection
Name, location, number of years, major and degree
Did you attend a Bus. or Trade School?
Clear selection
Name, location, number of years, major and degree
Do you have a Drivers License?
Proof of Automobile Insurance will be required as a condition of employment
Clear selection
Driver's License Number
State of Issue
Expiration Date
Have you had any accident during the past three years?
How many?
Have you had any moving violations during the past three years?
How many?
Have you ever been in the Armed Forces?
Clear selection
Are you now a member of the National Guard
Clear selection
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