Employment Application

Personal Information

Name*

First Last

Email address

Contact phone number*

How long have you been at your current address

Address*

Street Address Address 2 City State ZIP Code

List activities or commitments that may interfere with attendance requirements.

If requested, can proof of citizenship, Visa or Alien registration be provided?*

Yes
No

Will Visa immigration status prevent lawful employment?*

Yes
No

Have you ever applied for employment with the DSA?*

Yes
No

Approximate date*

Who referred you to the DSA?

First Last

Employment Interest and Skills

Type of employment desired

Permanent
Temporary
Summer

Hourly wage desired

Jobs preferred*

Clean Team
Safety Team
Parks Team

Specialized skills or training

Education

High School

High School address

Street Address City State / Province / Region ZIP / Postal Code Country

College

College address

Street Address City State / Province / Region ZIP / Postal Code Country

College 2

College address 2

Street Address City State / Province / Region ZIP / Postal Code Country

Employment Experience

Give past employment record as completely as possible, starting with your present or latest employer. If space is insufficient, list on separate page or attach resume. For any unemployed or self-employed periods, show dates and locations.

Job 1

Employer's name*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

From*

To*

Immediate supervisor*

Phone number*

Position*

Hourly wage*

Job 2

Employer's name

Address

Street Address City State / Province / Region ZIP / Postal Code Country

From

To

Immediate supervisor

Phone number

Position

Hourly wage

Job 3

Employer's name

Address

Street Address City State / Province / Region ZIP / Postal Code Country

From

To

Immediate supervisor

Phone number

Position

Hourly wage

References

Give names of three Indiviuals to who you are not related and by whom you have not been employed. These people should have known you for several years.

Reference 1

Name*

First Last

Position*

Phone*

Reference 2

Name

First Last

Position

Phone

Reference 3

Name

First Last

Position

Phone

Relatives and/or acquaintances employed by DSA

Name

First Last

Occupation

Relationship

Additional Information for Employment Consideration

Anything else you'd like us to know?

Upload resume

In addition to your application, if you would like to submit resume, please attach here.

Accepted file types: pdf, png, gif, jpg, doc, docx, Max. file size: 10 MB.

I authorize investigation of all statements contained in this application for employment. I understand that misrepresentation or omission of facts called for hereon will be sufficient cause of cancellation of consideration for employment or dismissal from the company’s service if I have been employed. I understand that employment is subject to physical examination in which my health is found to be satisfactory to the company. I understand that if I am employed, a certified birth certificate or other evidence of birthplace and citizenship is required.

Signature*

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Phone

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