Application for Employment

Thank you for your interest in Bend Metro Park and Recreation District. All qualified applicants will be considered without regard to race, religion, color, national origin, gender, age, marital status, the presence of mental, physical or sensory disability, sexual orientation or any other basis prohibited by federal, state or local law. Accommodations and/or assistance will be provided gladly for any applicant with sensory and nonsensory impairments by calling 541-389-7275.
* Required

Position Desired
Salary Desired
Date You Can Start
Todays Date
Post Date
Professional Information

* First Name
M.I.
* Last Name
* Address Line 1
Address Line 2
* City
* State
* Zip
Home Phone
Cell Phone
Work Phone
* E-mail Address
Referred By
* Are You Currently Employed	Yes	No
If So May We Contact Your Present Employer	Yes	No
* Have You Ever Been Employed By Us Before	Yes	No
If So, When
As an adult, have you ever been convicted of an offense other than a minor traffic violation?	Yes	No
If “yes”, please state below the nature, date and jurisdiction of each conviction. (Convictions are evaluated for each position, and are not necessarily disqualifying.)
Subjects of Special Interest/Study
U.S. Military Service
Dates
Present Membership In National Guard or Reserves
Education
High School
School Address
Number of Years
Degree/Diploma
College
School Address
Number of Years
Degree/Diploma
Trade, Business, or Other
School Address
Number of Years
Degree/Diploma
List any other skills or qualifications relating to the position desired
Employment History
Employer
Address
City, State, Zip
Phone Number
Position
Supervisor
Start Date
End Date
Starting Salary
Ending Salary
Reasons for Leaving
List Essential Job Functions
Employer
Address
City, State, Zip
Phone Number
Position
Supervisor
Start Date
End Date
Starting Salary
Ending Salary
Reasons for Leaving
List Essential Job Functions
Employer
Address
City, State, Zip
Phone Number
Position
Supervisor
Start Date
End Date
Starting Salary
Ending Salary
Reasons for Leaving
List Essential Job Functions
Employer
Address
City, State, Zip
Phone Number
Position
Supervisor
Start Date
End Date
Starting Salary
Ending Salary
Reasons for Leaving
List Essential Job Functions
Employer
Address
City, State, Zip
Phone Number
Position
Supervisor
Start Date
End Date
Starting Salary
Ending Salary
Reasons for Leaving
List Essential Job Functions
Additional Information
List Any Additional Training Which Applies To This Position
References (List 3 references you have known for at least one year, and whom are not related)
Reference Name and Phone
Reference Address
Business
Years Known
Reference Name and Phone
Reference Address
Business
Years Known
Reference Name and Phone
Reference Address
Business
Years Known

Certification, Authorization and Release

Marking the box below affirms that:

I authorize Bend Metro Park and Recreation District to check my references and to investigate any information provided in the application materials. I also release Bend Metro Park and Recreation District from liability which may result from making any investigation of information provided in the application materials.

I further authorize my past employers or anyone with information about my work history, education or qualifications to provide such information to Bend Metro Park and Recreation District in response to their inquiry. I release from liability any employer, person, agency, organization, or employee supplying information regarding me or my previous employment.

I certify that the facts and information given in this application, in any attachment or supporting documents and in any interviews are (or will be) true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission as well as any misleading statements or omissions, generally will result in denial of employment or immediate termination, regardless of when and how discovered.

I understand that I must prove that I am authorized to work in the United States if I am hired.

I understand and agree to be subjected to a pre-employment drug screening and a criminal history background check.

I understand that if employed my employment is for no definite period and I may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.

I agree I disagree