Big Sandy Lodge
Job Application

If you cannot print out out PDF application form, please print this page, fill it out, and mail it to us at #8 Spotted Trail Circle, Rock Springs, WY 82901.

Employee Application

APPLICANT INFORMATION

Full Name______________________________________________________________

Address_______________________________________________________________

     City_________________________________________________

     State/Country______________________    Zip Code___________________________

Phone (__________)________________    E-mail________________________________

Dates Available_____________________ Social Security #________________________

Position Applied for________________________________________________________

Are you a United States citizen?    Yes      No

   If no, are you authorized to work in the U.S.?    Yes     No

Have you ever been convicted of a felony?   Yes    No

   If yes, explain____________________________________________________________

________________________________________________________________________

EDUCATION

High School___________________________Address_____________________________

From__________________ To_____________________

Did you graduate?    Yes     No     Degree_____________________  

College______________________________Address______________________________

From__________________ To_____________________

Did you graduate?    Yes     No     Degree_____________________  

REFERENCES

Please list one professional reference, not including current employer.

Full name_________________________________________________________________

Relationship______________________________________________________________

Address__________________________________________________________________

Phone___________________________________________________

PREVIOUS EMPLOYMENT

Company___________________________________Phone________________________

Address_________________________________________________________________

Job Title __________________________Supervisor______________________________

Responsibilities___________________________________________________________

From__________________To__________________

Reason for Leaving_________________________________________________________

May we contact your previous supervisor for a reference?   Yes     No

MILITARY SERVICE

Branch______________________________From______________To________________

Rank at Discharge__________________________Type of Discharge__________________

If other than Honorable, explain_________________________________________________

Please use this space for additional information, hobbies, favorite pastimes and etc:

________________________________________________________________________________________

_________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. I am physically and mentally capable of performing the duties that will be assigned to me.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature__________________________________________________Date___________________________