Diversified Investments Companies
Employment Application

Personal Information Date of Application:
Park Name:
Position(s) Applied For:
Salary Desired:
Referral Source:
First Name:
Middle Name:
Last Name:

Address

Street:
City:
State:
Zip:
Social Security Number:
Home Phone:
Daytime Phone:
Date of Birth:
DL Number / State ID Number:
State:
Expiration Date:
Are you available for work (check all that apply):
FT
PT
Temporary
Seasonal
Weekends
Overtime

Are you currently employed?
Yes
No

If yes, give date available for work:
If you are under 18, can you furnish a work permit?
Yes
No

Have you filed an application with us before?
Yes
No

If yes, give dates. From: To:
Please list all places you've lived within past seven years (include city, state, and dates):


Are you legally eligible for employment in this country?
Yes
No

Have you ever been charged with a crime?
Yes
No

Have you ever been convicted of a misdemeanor or a felony? (A conviction will not necessarily disqualify you for employment)
Yes
No

If yes, please explain:
Employment History

List your last four (4) employers, assignments, or volunteer activities starting with the most recent including military experience. Explain any gaps in employment in comments section below.




Employer:
Telephone:
Address:
Dates Employed
From:
To:
Job Title:
Immediate Supervisor and Title:
Reason for Leaving:
May we contact for reference? Yes No Later

Starting Hourly Rate/Salary:
Final Hourly Rate/Salary:
Summarize the nature of the work performed and job responsibilities:



Employer:
Telephone:
Address:
Dates Employed
From:
To:
Job Title:
Immediate Supervisor and Title:
Reason for Leaving:
May we contact for reference? Yes No Later
Starting Hourly Rate/Salary:
Final Hourly Rate/Salary:
Summarize the nature of the work performed and job responsibilities:



Employer:
Telephone:
Address:
Dates Employed
From:
To:
Job Title:
Immediate Supervisor and Title:
Reason for Leaving:
May we contact for reference? Yes No Later

Starting Hourly Rate/Salary:
Final Hourly Rate/Salary:
Summarize the nature of the work performed and job responsibilities:



Employer:
Telephone:
Address:
Dates Employed
From:
To:
Job Title:
Immediate Supervisor and Title:
Reason for Leaving:
May we contact for reference? Yes No Later

Starting Hourly Rate/Salary:
Final Hourly Rate/Salary:
Summarize the nature of the work performed and job responsibilities:



Comments (including explanation of any gaps in employment):
Skills and Qualifications Summarize special skills and qualifications acquired from employment or other experiences that may qualify you for work with pacific union.
Educational Background

List last three (3) schools attended, starting with last one.




School:
No. Years Completed:
Degree Diploma:
GPA/Class Rank:
Major:
Minor:



School:
No. Years Completed:
Degree Diploma:
GPA/Class Rank:
Major:
Minor:



School:
No. Years Completed:
Degree Diploma:
GPA/Class Rank:
Major:
Minor:



List any foreign language(s) and check the box that best describes your skill level


Language 1: Read and Write
Read and Speak
Read Only
Speak Only

Language 2: Read and Write
Read and Speak
Read Only
Speak Only

Language 3: Read and Write
Read and Speak
Read Only
Speak Only

Language 4: Read and Write
Read and Speak
Read Only
Speak Only
References

List name and telephone number of three business/workreferences who are not related to you and are not previous supervisors. If not applicable, list thee school or personal references who are not related to you.


Name:
Relationship:
Years Known:
Telephone:

Name:
Relationship:
Years Known:
Telephone:

Name:
Relationship:
Years Known:
Telephone:


List professional, trade, business, or CMC associations and any offices held (exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, or other protected status)


Organization:
Offices Held:

Organization:
Offices Held:

Organization:
Offices Held:

List special accomplishments, publications, awards (exclude memberships which would reveal sex, race, religion, national origin, age, ancestry, handicap, or other protected status).

List any additional information you would like us to consider

AN EQUAL OPPORTUNITY EMPLOYER
Please read and check box below
(if there is any part of this statement you do not understand,
please ask the interviewer about it before signing the statement)
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 fact on this application or on any documents 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 hereby authorize the company to thoroughly investigate my references, work records, education and other matters related to my suitability for employment and, further authorize my current and former employees to disclose to the company any and all letters, reports and other information pertaining to my employment with them, without giving me prior notice of such disclosure. In addition, I hereby release the company, my current and 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 understand that nothing conveyed in the application or conveyed to me during any interview which may be granted, is intended to create an employment contract, implied or explicit, between the company and me. In addition, I understand and agree that if I am employed, my employment relationship with the company is strictly voluntary and of our mutual will. I understand and agree that if I am employed, my employment relationship with the company is strictly voluntary and at our mutual will. I understand that if employed, my employment is for no definite or determinable period and may be terminated at any time with or without prior notice with or without cause or reason, at the option of either myself or the company, ant that no promises or representations contrary to the forgoing are binding on the company unless made in writing and signed jointly by a principal of the company, a department manager and myself.
Furthermore, if employed, I agree that any dispute arising out of the termination of our employment relationship shall be resolved pursuant to mandatory binding arbitration at the written request of either the company or myself. This agreement provides that such arbitration shall comply with and be governed by the rules of the American Arbitration Association, and that any arbitration award arising from such dispute shall be limited to back pay only.
I understand an agree that any future changes in my titles, duties, compensation, working conditions, and/or company benefits, policies and procedures will not alter our at-will and arbitration agreements.
I understand that if offered employment, I will, as a condition of employment, be required to submit proof of my identity and legal right to work in the United States on my first day of employment.
If the position applied for required driving in the course of work, I understand that I will be required to possess a current and valid driver’s license and understand that I will be required to provide a copy of my official driving record and proof of insurance. I also understand that any offer of employment is contingent on my ability to be covered by the company’s auto insurance. If required for my position.
This company is an equal opportunity employer and does not discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant’s consideration for employment on a basis prohibited by local, state or federal law.



I hereby certify that the above information is accurate.
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