APPLICATION FOR EMPLOYMENT

Pelham Parks and Recreation

6 Village Green, Pelham, NH 03076    Phone:  (603) 635-2721

PLEASE PRINT CLEARLY:

Name:  ___________________________ Home Phone:  _____________

Address:  _________________________ Town/State:  _____________

Cell phone:  __________________ Email:  ________________________

Social Security No.  ____________________

Position Sought:  ____________________ Hourly rate:  _____________

If you’ve worked for us in the past, what position?  __________________

Are you a US Citizen?  ________ Can you furnish a work permit?  _______

Work Experience:

Dates:  _____________________ Contact person:  ________________

Name of employer:  _________________________ Phone:  __________

Reason for leaving:  _________________________ Pay rate:  ________

Work Experience:

Dates:  _____________________ Contact person:  _________________

Name of employer:  _________________________ Phone:  ___________

Reason for leaving:  _________________________ Pay rate:  _________

Experience working w/children:  _________________________________

Personal reference:  _________________________________________

Skills or qualifications:  _______________________________________

Where do you attend school, if any:  _____________________________

If graduated, school and date:  _________________________________

I certify that all of the above information is truthful and accurate and give permission to my employer to obtain further information as necessary.  I understand I will be required to provide identification if hired. 

_______________________________                        ______________

Applicant’s signature                                                       Date