EmailMe Form - Camillus Parks & Recreation Department

Position Applying For *

Select from the available positions.

Position Applying For *

Select from the available positions.

Date available *

MM / DD / YYYY

Please provide your first available date, if immediate then choose todays date.

Personal Information

...........................................................................................................................

Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email

Birth Date

MM / DD / YYYY

This information is used to determine minimum age for equipment operation

Gender *

Female

Male

not given

Education and Certifications

...........................................................................................................................

College/HighSchool Name *

Graduation Date *

MM / DD / YYYY

If the actual date of graduation is NOT known OR is in the FUTURE, choose June 15th of the YEAR of graduation/anticipated graduation.

Certifications

First Aid Certification

Life Guard Training

CPR

Water Front Module

Water Safety Instructor

Check any of the following you have completed and hold a CURRENT certification.

Certification expiration dates will be verified if interviewed.

Additional Certification(s). If applying for Ice Arena,
please indicate here if you
can skate.

Employment Information

Pease provide previous employment, references and relevant experience
...........................................................................................................................

Previous Employment? *

YES, I have been employed by this department

NO, I have not been employed by this department

Never held any type of employment

Relatives employed by Town of Camillus

If you have never help any type of employment, simply skip the Previous Employer section.

If you have any relatives currently or previously employed by the Town of Camillus, please list names.

References

Please provide up to three (3) references

First Reference Name *

First Last

First Contact info *

Please provide a Phone, Email, or Address

Second Reference Name *

First Last

Second Contact info *

Please provide a Phone, Email, or Address

Experience

Describe any previous employment experience that qualifies you for the position applying for.

Employer Name

Type of Business

Your Title and Duties

Reason for leaving

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

estimated dates are acceptable

Employer Name

Type of Business

Your Title and Duties

Reason for leaving

Start Date

MM / DD / YYYY

End Date

MM / DD / YYYY

estimated dates are acceptable

Leadership

List any specific experience or honors received working with the Public or while in School or on the Job

Activities

List any specific activities you have conducted or possess the ability to conduct

Other

List any other relevant information you wish to provide

Attach your resume:

If you have a resume and would like to attach it to this application

Certification *

I confirm

I hereby certify that all statements made and information provided in connection with this application for employment are true and I authorize the Town of Camillus Parks and Recreation Department to obtain personal information about me.

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