Employment Application

"*" indicates required fields

1Personal Information

2Education, Training and Skills

3Employment History and References

Legal Name*

First Last

Do you have a preferred name*

Name

Address*

Street Address City State ZIP Code

Cell Phone*

Can we send updates and other info via text?*

Yes

Email*

*Please Note: We rely on emails as our form of communication. Please provide an email that will be frequently accessed at time of applying.

How were you referred to this position?*

Job Interest

Please select the top 3 positions in order of preference.*

Job Interest (#2)*

Job Interest (#3)*

Are you open to being trained in multiple departments?*

Yes

Availability

Niabi Zoo is open every day from 10:00 am-5:00.

When are you available to start work?*

MM slash DD slash YYYY

What is your anticipated last day of work for the season?*

MM slash DD slash YYYY

School Students or School Employees- When is your last day of School?

MM slash DD slash YYYY

Please select how many days per week you would like to work starting in April ?*

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For School Students/Employees-When is your last day of school?

MM slash DD slash YYYY

Please select how many days per week you would like to work in the summertime?*

If you know of any extended time off that will be needed March-October (i.e., vacations, prior commitments), please put the dates below and/or any other information that would be helpful*

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Current Availability Starting in April

Monthly Availablity

Please remember we are open every day 10:00 am-5:00 pm. Any hours you can work after 5 pm do not count as availability.

April Availablity*

May Availability*

June Availability*

July Availability*

August Availability*

September Availability*

October Availablity*

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Monday*

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Tuesday*

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Wednesday*

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Thursday*

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Friday*

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Saturday*

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Sunday*

The following holidays and holiday weekends are mandatory for most positions. Are you available to work?

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Memorial Day*

Yes

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July 4th*

Yes

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Labor Day*

Yes

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Boo at the Zoo (Last weekend in Oct)*

Yes

Have ever been employed by Rock Island County Forest Preserve District?*

Yes

Which position(s)?*

Date(s)?*

Have you ever been terminated, discharged, or asked to resign from any employment?*

Yes

Please briefly explain*

In the last seven years have you ever been convicted of a violation of law other than a minor traffic violation (i.e. speeding ticket or failure to obey a traffic signal)?*

Yes

Please briefly explain*

Applicant not obligated to disclose expunged juvenile records of adjudication or arrest. The term “convicted” includes any conviction, a guilty plea, a no contest plea, a suspended sentence, or a deferred judgment. Conviction of a crime does not necessarily constitute automatic bar from employment.

Do you have a legal right to work in the U.S.?*

All new hires will be required to submit verification of the legal right to work in the United States within (3) business days of employment. In accordance with the Immigration Reform and Control Act of 1986 we are legally prohibited from employing anyone who cannot provide such verification.

Yes

Are you 18 years of age or older?*

Yes

Driver's License Information

Proof of education and/or professional certifications may be required prior to hire.

Do you have a valid driver’s license?*

Yes

State*

CDL?*

Yes

List any CDL endorsements

Education

Do you have a high school diploma or G.E.D.?*

Yes

If no, please indicate the highest grade completed.

Education #1

Name of High School / College / University*

Major, if applicable

Type of Degree, if applicable

Degree Completed?*

Yes

Credit Hours

Add Education #2

Yes

Education #2

Name of High School / College / University*

Major, if applicable

Type of Degree, if applicable

Degree Completed?

Yes

Credit Hours

Add Education #3

Yes

Education #3

Name of High School / College / University*

Major, if applicable

Type of Degree, if applicable

Degree Completed?

Yes

Credit Hours

Add Education #4

Yes

Education #4

Name of High School / College / University*

Major, if applicable

Type of Degree, if applicable

Degree Completed?

Yes

Credit Hours

Professional Registrations, Licenses, and/or Certifications that relate to this position

Professional Registration, License or Certification #1

Type of Professional Registration, License, and/or Certification

License Number, if applicable

Date Received

MM slash DD slash YYYY

Expiration Date, if applicable

MM slash DD slash YYYY

Add Professional Registration, License or Certification #2

Yes

Professional Registration, License or Certification #2

Type of Professional Registration, License, and/or Certification

License Number, if applicable

Date Received

MM slash DD slash YYYY

Expiration Date, if applicable

MM slash DD slash YYYY

Add Professional Registration, License or Certification #3

Yes

Professional Registration, License or Certification #3

Type of Professional Registration, License, and/or Certification

License Number, if applicable

Date Received

MM slash DD slash YYYY

Expiration Date, if applicable

MM slash DD slash YYYY

Training and Skills

List any specialized training you have received that relates to this position

List equipment and/or computer software applications you are proficient in operating that relate to this position

Employment History-Please begin with your most current employer

Begin with your present or most recent employer. List all jobs, paid or volunteer, over the last five years. Include experience prior to five years ago if it relates to the position to which you are applying. Your qualifications will be evaluated based in part on the information you provide on this application form.

Employer #1

Employer

Employer Phone

Position Title

Employment Date Range

Employer Address

Street Address City State ZIP Code

Direct Supervisor

Direct Supervisor's Phone

Annual Salary (optional)

Hours per Week

Job Duties

May we contact this employer?

Yes

Reason for leaving or wanting to leave?

Add Second Employer

Yes

Employer #2

Employer

Employer Phone

Position Title

Employment Date Range*

Employer Address

Street Address City State ZIP Code

Direct Supervisor

Direct Supervisor's Phone

Annual Salary (optional)

Hours per Week

Job Duties

May we contact this employer?

Yes

Reason for leaving or wanting to leave?

Add Third Employer

Yes

Employer #3

Employer

Employer Phone

Position Title

Employment Date Range*

Employer Address

Street Address City State ZIP Code

Direct Supervisor

Direct Supervisor's Phone

Annual Salary (optional)

Hours per Week

Job Duties

May we contact this employer?

Yes

Reason for leaving or wanting to leave?

Add Fourth Employer

Yes

Employer #4

Employer

Employer Phone

Position Title

Employment Date Range*

Employer Address

Street Address City State ZIP Code

Direct Supervisor

Direct Supervisor's Phone

Annual Salary (optional)

Hours per Week

Job Duties

May we contact this employer?

Yes

Reason for leaving or wanting to leave?

Professional References

Provide at least three.

Reference #1

Name*

Relationship*

Contact Number*

Address*

Street Address City State ZIP Code

Add Reference #2

Yes

Reference #2

Name*

Relationship*

Contact Number*

Address*

Street Address City State ZIP Code

Add Reference #3

Yes

Reference #3

Name*

Relationship*

Contact Number*

Address*

Street Address City State ZIP Code

Add Reference #4

Yes

Reference #4

Name*

Relationship*

Contact Number*

Address*

Street Address City State ZIP Code

Agreement*

I agree to the terms below.

I hereby certify that the statements made on this employment application are accurate and complete to the best of my knowledge. I understand that if I provide any false, inaccurate, incomplete, or misleading information I may not be eligible for employment and if hired I will be subject to termination.