Addison Park District
120 East Oak Street
Addison, Illinois 60101
(630) 233-7275

Application for Employment

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!

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 Position
Date Ended

Ending Position
Name of Supervisor

May We Contact? *
Yes
No
Responsibilities
Reason for Leaving
——–
Company Name
Address
Telephone
Date Started

Starting Position
Date Ended

Ending Position
Name of Supervisor

May We Contact? *
Yes
No
Responsibilities
Reason for Leaving
——–
Company Name
Address
Telephone
Date Started

Starting Position
Date Ended

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

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employees, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resumé or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this employer does not lawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that I must successfully pass a criminal background check performed with the Illinois State Police pursuant to Section 8-23(c) of the Illinois Park District Code and understand that the Park District cannot employ persons with certain convictions.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer’s service, whenever it is discovered.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand, and accept all terms of the foregoing Applicant Statement.

Signature of Applicant * (type your name as your digital signature in the box below)
Signature Date *