Application Form Name * First Name Last Name Email * Phone Country (###) ### #### Street Address City/State Zip Code If hired, can you provide evidence of legal eligibility to work in the US? Yes No Position Desired * Wage/Salary Desired Full Time Part Time Date you can begin work MM DD YYYY Are you 18 years of age? Yes No Name of high school attended: City & State Graduation Date MM DD YYYY Name of college or technical school : City & State Degree & Major Graduation Date MM DD YYYY Are you presently enrolled in school? If yes, give name & Address and expected degree date List any job-related skills or accomplishments, license(s) or certifications, including military service (attach copy of license(s), certificate(s), DD214: Total Hours per week you are available to work : Are you willing to work overtime : Yes No If not why not : Do you have any special requests or needs for a work schedule? Is there anything that can prevent you from doing this job? Yes No if yes, please explain : Do you understand the job duties/requirements & working in all types of weather conditions? Yes No if no, please explain : Can you lift 50lbs? Yes No if no, please explain : Are you capable of walking & standing for long periods & climbing railcars? Yes No if no, please explain : Do you have a valid driver’s license? Yes No if no, please explain : Have you ever been convicted of a felony? Yes No IF YES, YOU MUST EXPLAIN, INCLUDE THE DATE(S), TYPE OF OFFENSE(S), CITY, STATE AND COUNTY OF CONVICTION(S): Give Three References That Are Not Former Employers or Family Members We May Contact Name, Occupation, How long you have known them, Phone number Employment History: List Names of employers with present or last employer first. Note if we may NOT contact your present employer until after you are offered a position. If there is a job gap explain the reason. Name of Employer : Address : City, State & Zip : Supervisor Telephone : Job Title & Duties : Dates of Employment : Reason for Leaving : Name of Employer : Address : City, State & Zip : Supervisor Telephone : Job Title & Duties : Dates of Employment : Reason for Leaving : Name of Employer : Address : City, State & Zip : Supervisor Telephone : Job Title & Duties : Dates of Employment : Reason for Leaving : I certify that all of the information provided in this employment application are true and complete to the best of my knowledge, and I authorize investigation of all statements contained in this application, including a criminal background and credit history check. I understand that any false or incomplete information may disqualify me from further consideration for employment and may result in my immediate discharge if discovered at a later date. I understand and acknowledge that unless otherwise defined by applicable law or written agreement with Squaw Creek Southern Railroad, any employment relationship with the Squaw Creek Southern Railroad, is considered “employment at will”. This means the Employee may resign at any time and the Employer may discharge the Employee at any time, with or without cause, and with or without advance notice. I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer, past employers, and other organizations to provide information concerning my previous employment and other relevant information that may be useful n making a hiring decision. I release such persons and organizations from any legal liability in making such statements. * I have read, understand, and agree to the above statements. Date MM DD YYYY Thank you!
