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Employment Application

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EMPLOYMENT APPLICATION

INSTRUCTIONS: Answer all questions completely and honestly. Type or print all answers. Sign the application and any supplemental forms. An applicant will not be considered without a completed application. Resumes are accepted, but only in addition to the application. Any omission, mis-statement, or falsification may be cause for you to be removed from further consideration in the employment process or discharged from District service. Applications must be received by the posted deadline, whether submitted in person, by fax, or by e-mail. The Rock Island County Forest Preserve District is not responsible for applications that are not received by the posted deadline.

An asterisk (*) denotes a required field.

Proof of education and/or professional certifications may be required prior to hire.

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GENERAL INFORMATION

*Position Applying For:

Date Available:

*Name (First)

*Name (Middle Initial):

*Name (Last):

*Address:

*State:

ZIP code:

Telephone:

Other Phone:

*Email Address:

Have you ever used or been known by any other names?

Yes

No

Names:

How were you referred to this position?

Desired Salary:

Minimum Salary Acceptable (Optional):

Have ever been employed by Rock Island County Forest Preserve District?

Yes

No

If yes: Position:

If yes: Date:

Have you ever been terminated, discharged, or asked to resign from any employment?

Yes

No

If yes, please briefly explain:

In the last seven years have you ever been convicted of a violation of law other than a minor traffic violation?

Yes

No

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(Applicant not obligated to disclose expunged juvenile records of adjudication or arrest.) (The term “convicted” includes any conviction, a guilty plea, a no contest plea, a suspended sentence, or a deferred judgment. Conviction of a crime does not necessarily constitute automatic bar from employment.)

If yes, please explain:

I will accept (check all that apply) Regular:

Full Time

Part Time

*I will accept (check all that apply) Temporary:

Full Time

Part Time

Seasonal

I will accept (check all that apply) Shifts:

Days

Evenings

On Call

Available to start work:

*Do you have a legal right to work in the U.S.?

Yes

No

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All new hires will be required to submit verification of the legal right to work in the United States within (3) business days of employment. In accordance with the Immigration Reform and Control Act of 1986 we are legally prohibited from employing anyone who cannot provide such verification.

Are you 18 years of age or older?

Yes

No

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DRIVER’S LICENSE INFORMATION:

*Do you have a valid driver’s license?

Yes

No

State:

CDL?

Yes

No

List any CDL endorsements:

*Do you have a high school diploma or G.E.D.?

Yes

No

If no, please indicate the highest grade completed:

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EDUCATION INFORMATION:

Name of High School:

Major:

Type of Degree:

Degree Completed:

Yes

No

Credit Hours:

Name of College:

Major:

Type of Degree:

Degree Completed:

Yes

No

Credit Hours:

Name of University:

Major:

Type of Degree:

Degree Completed:

Yes

No

Credit Hours:

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PROFESSIONAL REGISTRATIONS, LICENSES, AND/OR CERTIFICATIONS THAT RELATE TO THIS POSITION:

Type of Professional Registration, License, and/or Certification:

License Number:

Date Received:

Expiration Date:

List any specialized training you have received that relates to this position:

List equipment and/or computer software applications you are proficient in operating that relate to this position:

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EMPLOYMENT HISTORY

Employer:

Phone #:

Position Title:

Employment Dates (mo/yr):

Employment Dates (mo/yr):

Address:

City:

State:

ZIP code:

Direct Supervisor:

Phone #:

Hours per week:

Job Duties:

May we contact this employer?

Yes

No

Reason for leaving or wanting to leave?:

Employer:

Phone #:

Position Title:

Employment Dates (mo/yr):

Employment Dates (mo/yr):

Address:

City:

State:

ZIP code:

Direct Supervisor:

Phone #:

Hours per week:

Job Duties:

May we contact this employer?

Yes

No

Reason for leaving or wanting to leave?:

Employer:

Phone #:

Position Title:

Employment Dates (mo/yr):

Employment Dates (mo/yr):

Address:

City:

State:

ZIP code:

Direct Supervisor:

Phone #:

Hours per week:

Job Duties:

May we contact this employer?

Yes

No

Reason for leaving or wanting to leave?:

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PROFESSIONAL REFERENCES - PROVIDE AT LEAST 3

Name:

Contact #:

Address:

Relationship:

Name:

Contact #:

Address:

Relationship:

Name:

Contact #:

Address:

Relationship:

Name:

Contact #:

Address:

Relationship:

Signature:

Signature Date:

Opt-In

By checking, I am confirming my digital signature and the signature date above.

Thank you for submitting your online application. We will carefully consider your application and contact you if your qualifications meet our needs.

Oops, there was an error sending your message.
Please try again later.

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Indian Bluff Golf Course 6200 78th Avenue, Milan, IL 61264 (309) 799-3868
© Copyright 2021 Indian Bluff Golf & Forest Preserve. All rights reserved.
A Rock Island County Forest Preserve

Rock Island County Forest District

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