Application for Employment/Pre-Employment Questionnaire

Addison Park District
120 East Oak Street
Addison, Illinois 60101
(630) 833-0100

Employment with the Addison Park District is governed on the basis of merit, competence and qualifications and will not be influenced in any manner by race, age, color, sex, religion, veteran status, national origin, marital status, mental or physical disabilities.

NOTE: Fields marked with * below are the minimum requirements to submit your application! But you should fill out the form as completely as possible to ensure we can fully consider your application.

Personal Information

Last Name *
First Name *
Middle
Street *
City *
State *
Zip *
Home Phone (xxx) xxx-xxxx
Cell Phone (xxx) xxx-xxxx
Email Address *
Are you at least 18 years of age? *
Yes
No
Are you at least 16 years of age? If hired, proof will be required. *
Yes
No
Do you have transportation? *
Yes
No
Are you legally eligible for employment in the United States? *
Yes
No
Proof of citizenship or immigration status will be required.
Type of Employment Desired *
Date you can Start
Requested Salary
Type of Position Desired (i.e. Camp Counselor, KEEP, Lifeguard, etc.) *
Have you ever been employed by us before? *
Yes
No
Approx date(s)
Position
Supervisor
Special skills, qualifications, licenses, or certifications that would make you uniquely qualified for employment here?
Yes
No
If yes, please list
Have you ever been convicted of a felony? *
Yes
No
If yes, please explain. Conviction may not necessarily disqualify application from employment
Type of Offense
Date Occurred
Please state circumstances

Educational Background

High School
City/State
Years Completed
Course of Study
Diploma or Degree
College
City/State
Years Completed
Course of Study
Diploma or Degree
Other
City/State
Years Completed
Course of Study
Diploma or Degree
Describe any specialized training, apprenticeships, or extra-curricular activities completed or honors received or additional information that will be helpful to us on considering your application.

Employment History

(Start with the most recent)
Company Name
Address
Telephone
Date Started
Starting Wage
Starting Position
Date Ended
Ending Wage
Ending Position
Name of Supervisor

May We Contact? *
Yes
No
Responsibilities
Reason for Leaving
——–
Company Name
Address
Telephone
Date Started
Starting Wage
Starting Position
Date Ended
Ending Wage
Ending Position
Name of Supervisor

May We Contact? *
Yes
No
Responsibilities
Reason for Leaving
——–
Company Name
Address
Telephone
Date Started
Starting Wage
Starting Position
Date Ended
Ending Wage
Ending Position
Name of Supervisor

May We Contact? *
Yes
No
Responsibilities
Reason for Leaving

References

Name
Address
Phone
Occupation
Yrs. Known
Name
Address
Phone
Occupation
Yrs. Known
Name
Address
Phone
Occupation
Yrs. Known
Upload resume