Recreation Employment Application

Applicants are considered for all positions without regard to race, color, sex, sexual orientation, religion, creed, national origin, ancestry, age, marital or veteran status, disability, handicap or arrest or conviction record.

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Personal Data

First Name *

Middle Initial *

Last Name *

Address *

City *

State *

Zip Code *

Telephone *

Email Address *

Employment Eligibility

As of May 1, 2023 I will be 16 years of age? *

As of May 1, 2023 I will be 17 Years of Age *

As of May 2, 2023, I will be 18 Years of Age? *

Education

Are you presently a full time student? *

If Yes

Name of High School and Year of Graduation *

Provide Name & Location, Course of Study, Dates, and Degree/Diploma

Name of College and Year of Graduation

Provide Name & Location, Course of Study, Dates, and Degree/Diploma

Major Course of Study (If Applicable)

Job Experience

Most Recent Employer

Provide the employer name, address, supervisor's name and telephone number.

Most Recent Job Title

Most Recent Job Duties

Most Recent Dates of Employment

Provide beginning and ending employment dates.

Most Recent Reason for Leaving

2nd Most Recent Employer

Provide the employer name, address, supervisor's name and telephone number.

2nd Most Recent Job Title

2nd Most Recent Job Duties

2nd Most Recent Dates of Employment

Provide beginning and ending employment dates.

2nd Most Recent Reason for Leaving

3rd Most Recent Employer

Provide the employer name, address, supervisor's name and telephone number.

3rd Most Recent Job Title

3rd Most Recent Job Duties

3rd Most Recent Dates of Employment

Provide beginning and ending employment dates.

3rd Most Recent Reason for Leaving

First Aid/ Special Training

Do you have a first aid certificate *

If yes, please list date received and expiration date

Are you first aid instructor certified? *

If yes, please list date received and expiration date

Are you certified in CPR? *

If yes, please list date received and expiration date

Other applicable certifications?

If yes, please list date received and expiration date

Please attach a coy of you certifications to this application.

Activities

Please list all activities that you have supervised, officiated, or actively participated in that pertain to the job you are applying for:

NOTE: Place a "*" behind any activity that you have supervised or officiated.

General Information

Do you plan to attend summer school? *

Are you available for morning work? *

Are you available for afternoon work? *

Are you available for evening work? *

What DAYS are you available? *

What HOURS are you available? *

What MONTHS are you available? *

Enter the month and day you can begin work and the last month and day you are available to work.

Do you have a VACATION planned for this summer? *

If yes, please list dates

References

References *

Give name, address and telephone number of three references who are not related to you and are not previous employers.

Supporting Information

Certifications

Upload your certifications
Files must be less than 5 MB.
Allowed file types: txt pdf doc docx.

Cover Letter

Upload your cover letter.
Files must be less than 5 MB.
Allowed file types: txt pdf doc docx.

Resume

Upload your resume.
Files must be less than 2 MB.
Allowed file types: txt pdf doc docx.

Certification

By signing below, I certify that all statements made on this application are true and correct. I understand that all information is subject to verification. I also understand that any falsification will disqualify me from employment or, if already employed, will result in dismissal. My signature authorizes the City of Dodgeville to secure my driving record (if the position requires driving), transcripts from educational institutions to verify credits/degrees, employment-related information from former employers or references, and any information needed to complete a criminal background check. I understand that I may be asked to undergo a physical examination, including substance abuse screening, prior to appointment to a position with the City of Dodgeville; I also understand that refusal to participate will result in the withdrawal of any offer of employment.

Signature *

Type Your Full Name

Parent Signature *

Type Your Full Name

Date *

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Recreation Employment Application

Applicants are considered for all positions without regard to race, color, sex, sexual orientation, religion, creed, national origin, ancestry, age, marital or veteran status, disability, handicap or arrest or conviction record.

Contact Information