Employment Application

First Name		Last Name

Address

Town/City		State		Zip

School		Major

Present Status		Year Graduated

Home Phone

Cell Phone

Email Address

Previous Employment

1.	Employer	Dates of Employment

	Title	Duties

	Phone	Address

2.	Employer	Dates of Employment

	Title	Duties

	Phone	Address

3.	Employer	Dates of Employment

	Title	Duties

	Phone	Address

References

1.	Name	Telephone

	How do they Know you?
2.	Name	Telephone

	How do they Know you?
3.	Name	Telephone

	How do they Know you?

Other

We simply want to get to know you better! Don't worry about being humble.

Previous Outdoor and/or Wilderness Experience

Special Talents, Abilities, or Achievements. Try to impress us!

Short-Term Goals (1-3 Years)

Long-Term Goals (What and where do you want to be in 10 years)

Check the following qualifications that you currently have
Standard First Aid
Wilderness First Aid
Wilderness First Responder or EMT
CPR
Swiftwater Rescue
Other

Are you a smoker? Yes No
Do you have a reliable truck or car? Yes No