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2. Position Applied for*
   -- Select One --On-Call Crisis Nursery Worker OSTA Maintenance TechnicianMotorized Trails Ambassador (PART TIME SEASONAL) Trail Ambassador (Biking Focus) Trail Ambassador (Climbing Focus)Trail Ambassador (Hiking Focus)Deputy County Attorney
3. Date of Application
   Date of Application
5. Last Name
6. First Name
7. Middle Name
9. Physical Address
11. City
12. State
13. Zip Code
15. Mailing Address
    If different from physical address
17. Home Phone
18. Cell Phone
19. Other Phone
21. Email Address
23. Equal Employment Opportunity
    Grand County is an equal employment opportunity employer. If you meet the minimum position qualifications, your application will not be rejected because of your race, color, national origin, religion, sex, age, or disability.
25. Employment Desired

    1. Full Time
    2. Part Time
    3. Seasonal
27. Have you previously been employed by Grand County?

    1. Yes
    2. No
29. Are you legally eligible for employment in the United States?

    1. Yes
    2. No
30. Can you provide proof of eligibility for employment in the United States?

    1. Yes
    2. No
31. Do you meet the minimum age requirements for the position?

    1. Yes
    2. No
33. Have you read the job description of the position for which you are applying?

    1. Yes
    2. No
34. Do you feel that you are capable of performing all basic functions of the job within reason?

    1. Yes
    2. No
36. If no, please explain the reasonable accommodations that you may need to perform the basic job duties of the position for which you are applying.
38. Note:
    We comply with ADA requirements and consider reasonable accommodation measures that may be necessary for eligible applicants to perform essential functions. Employment may be subject to passing a medical examination and skill/agility testing.
42. Education
44. Highest Form of Education
45. Degree

    1. Yes
    2. No
46. Major/ Type of Degree
48. List any languages, other than English, in which you are fluent.
50. List any professional or trade licenses, specialized training, certificates, and registrations.
52. List any other experience, training, qualifications, or skills you have that you feel will assist you in the position for which you are applying.
56. Employment Experience

    Chronologically list previous employment starting with the most recent for the past ten years. **IF YOU ARE ATTACHING A RESUME, YOU DO NOT NEED TO COMPLETE THIS SECTION. **

58. Resume Upload
60. Employer
61. May we contact this employer?

    1. Yes
    2. No
63. Address
65. Telephone Numbers
66. Job Title
68. Job Duties
70. Dates (Month / Year)
    From - To
72. Reason for Leaving
73. Supervisor's Name
74. Supervisor's Title
76. Employer
77. May we contact this employer?

    1. Yes
    2. No
79. Address
81. Telephone Numbers
82. Job Title
84. Job Duties
86. Date (Month / Year)
    From - To
88. Reason for Leaving
89. Supervisor's Name
90. Supervisor's Title
94. References (Optional)

    Please provide references that have knowledge of your skills, abilities and past work performance.

     

96. Name
97. Business Name & Address
98. Telephone Number
100. Name
101. Business Name & Address
102. Telephone Number
104. Name
105. Business Name & Address
106. Telephone Number
108. Additional Materials Upload
110. Read the Following Paragraphs Carefully Before Signing this Statement.
112. By making this application, I hereby authorize any previous employers or references to give and release to the Grand County Personnel Department any and all information of whatever kind in either written or verbal form which relates to my ability to perform the duties of the position for which I am applying. Any or all previous employers may be contacted. I release Grand County from any liability for the use of this information in considering and reviewing my application for the available position.
113. Initial
115. If I am applying for a position that lists as part of the job description the special requirement of passing a criminal history background investigation I hereby authorize Grand County to conduct a thorough background investigation, to include identifying criminal offenses of which I may have been convicted. I hereby release Grand County or any other agency involved in releasing this information from any civil or criminal liability arising under law.
116. Initial
118. I affirm that this application for employment and any additional documentation contain no misrepresentations or falsifications and that the information is true and complete to the best of my knowledge and belief. I am aware, that should investigation at any time disclose any such misrepresentation or falsification I will be disqualified from further consideration or, if employed by Grand County, I may be terminated from employment.
119. Initial
121. I understand that Grand County is a drug free workplace conducting pre-employment, reasonable suspicion, post accident and follow-up drug testing for the illegal use of controlled substances. If the position for which I am applying for is considered safety sensitive, I understand that I am subject to random drug testing.
122. Initial
124. Signature
125. Date Signed
     Date Signed
Leave This Blank:


127. 1. Receive an email copy of this form.
128. Email address

     This field is not part of the form submission.

129. Submit

* indicates a required field