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Employment Application

Name*
Date
Date
Address*
Street, P.O. Box or Apartment Number
City*
State*
Zip Code*
Telephone*
Cell Phone Number
Email
Position Applied For*
Acceptable Salary / Rate of Pay
Date Available for Employment
Date Available for Employment
High School Diploma
1. Yes
2. No
GED
1. Yes
2. No
College Education
List college education, begin with the most recent.
School
Major
Degree
School
Major
Degree
School
Major
Degree
Have You Ever Served on Active Duty With the United States Armed Forces?
1. Yes
2. No
If Yes, Please List Military Duties
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May We Contact Employers for Verification of Information?*
1. Yes
2. No
From
To
Employer (Firm Name)
Address
City
State
Zip Code
Position and Duties
Name and title of Supervisor
Starting Salary
Final Salary
Telephone
Reason for Leaving
From
To
Employer (Firm Name)
Address
City
State
Zip Code
Position and Duties
Name and title of Supervisor
Starting Salary
Final Salary
Telephone
Reason for Leaving
From
To
Employer (Firm Name)
Address
City
State
Zip Code
Position and Duties
Name and title of Supervisor
Starting Salary
Final Salary
Telephone
Reason for Leaving
Are There Other people Who Can Provide Information Regarding Your Work History?
1. Yes
2. No
If Yes, Please List Their Names & Phone Numbers
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Name
Occupation
Name of Business
Phone
Name
Occupation
Name of Business
Phone
Name
Occupation
Name of Business
Phone
Job Description
I have provided a copy of a job description for the position I am applying for.
Job Description
I have provided a copy of a job description for the position I am applying for and certify that I can perform all the essential functions in the job description.
1. Yes
2. No
If No, What Reasonable Accommodations Are You Requesting?
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Authorization
I authorize the investigation of all facts contained in this application together with any and all other facts which are reasonably necessary to determine my suitability for employment. I understand that I may be requested to complete a physical examination including a test for drugs and alcohol, if required by my position.

I also understand that any misrepresentation or omission of facts called for is cause for rejection of this application or dismissal after employment.
Applicant Signature*
By typing your name in the field provided you are hereby authorizing Angel Fire, New Mexico to accept this as your electronic signature.
Date*
Date
Equal Opportunity Employer
The Village of Angel Fire is an Equal Opportunity Employer.

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