Employment Application


Personal Information

First Name
Last Name
Email Address
Address Line 1
Address Line 2
City
Postal Code
Phone Number
Date Of Birth
Driver License # Or Student ID #
Highest Level of Education Completed
Have you ever been convicted of a crime?

If so when and what type of crime?

Former Employer

First Name
Last Name
Organization
Title
Address Line 1
Address Line 2
City
Postal Code
Phone Number
Job Title
Start Date
End Date
Reason for Leaving

Former Employer

First Name
Last Name
Organization
Title
Address Line 1
Address Line 2
City
Postal Code
Phone Number
Job Title
Start Date
End Date
Reason for Leaving

References

Name
Phone Number
Name
Phone Number

Desired Employment

Desired Position
Desired Salary
Date You Can Start
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise and release the Walworth County Fair from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the Walworth County Fair has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized Walworth County Fair representative."
Authorization
 

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