Kirkwood Mountain Resort

General Information

Name

First

Middle

Last

SSN

Local Mailing Address

P.O./ Street

City

State

Zip

Permanent Mailing Address

P.O./Street

City

State

Zip

Home Telephone

Alt. Phone

Email Address

Driver License No.

State

Expiration

Please list all relatives who are employed by KIRKWOOD:
Name(s)	Relationship	Department(s)

Please list most recent employment ar KIRKWOOD:
Position	Department	Dates employed

Are you at least 18 years of age (If under 18, hire is subject to verification that you are of minimum legal age)? Yes No

If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country? Yes No

Have you ever been convicted of a criminal offense (felony or serious misdemeanor)?     Yes   No
If yes, state nature of the crime(s), when and where convicted and disposition of the case :
   NOTE: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.

Do you have local housing?     Yes    No
If you do not live locally do you plan to relocate?     Yes    No
If hired, would you have a reliable means of transportation to and from work?                                               Yes    No

Skiing/snowboarding ability: Do not ski/snowboard Beginner Expert Intermediate Advanced

Referred to Kirkwood by: Newspaper School Kirkwood Employee Friend Walk-in Other
Please give name:

Employment Desired

Position/Department in order of preference:

1. 2.

Please list any positions or locations you will not accept:

Please note any days or hours you cannot or prefer not to work:

Are you able to perform the essential functions of the positions for which you
are applying? Yes No
If no, describe the functions that cannot be performed:

Are you able to perform all other duties of the positions for which you are applying? Yes No
If no, describe the functions that cannot be performed:

NOTE: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Here may be subject to passing a medical examination, and to skill and agility tests

Full Time (32+hours per week) Part Time (less than 32 hours per week) Winter Season Summer Season Year-round Temporary work (i.e. holidays)

If hire, first day you can start work:

If you are applying for a seasonal position, on what date do you plan to terminate?

Are you employed now? Yes No
If so, may we contact your present employer? Yes No

Education

High School

Name and Location of School

Did you graduate ?

Subject Studied

College or Other School

Name and Location of School

Did you graduate ?

Subject Studied

Are you currently attending school? Yes No

What school do you attend?

Date school ends Spring Quarter?

Date school starts Fall Quarter?

What school do you plan to attend next?
When does it start?

Special Skills, Talents, or Certification:

CPR, Card Expires: Standard First Aid, Card Expires:
EMT, Card Expires: Heavy Equipment:
Class B License:

Do you speak, read, or write any foreign languages? Yes No
If so, which language(s)?

Employment History -This section must be completed to be considered for any position. If you have no employment history write N/A in Job Title.

List below all present and past employment, beginning with your most recent employer. Account for all periods of unemployment.

Job Title		Employer	Address	Telephone
From	To	Supervisor's Name	Department	Hourly Rate/Salary
Job Duties Reason for Leaving

Job Title		Employer	Address	Telephone
From	To	Supervisor's Name	Department	Hourly Rate/Salary
Job Duties Reason for Leaving

Job Title		Employer	Address	Telephone
From	To	Supervisor's Name	Department	Hourly Rate/Salary
Job Duties Reason for Leaving

References
List below two (2) persons not related to you whom you have known at least three years.

Name

Telephone

Years Known

Name

Telephone

Years Known

Certification (Please read carefully)

I hereby authorize KIRKWOOD MOUNTAIN RESORT or its subsidiaries to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to KIRKWOOD MOUNTAIN RESORT any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release KIRKWOOD MOUNTAIN RESORT, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material facts on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and KIRKWOOD MOUNTAIN RESORT. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or KIRKWOOD MOUNTAIN RESORT, and that no promises or representations contrary to the foregoing are binding on KIRKWOOD MOUNTAIN RESORT unless made in writing and signed by me and KIRKWOOD MOUNTAIN RESORT's designated representative.

Signature (Name): Date: