Position Desired: Non-Supervisory Supervisory	1.	Locations Desired:
	2.
	3.
Name:
Social Security:
Address: (current)
(City/State/ZIP: (current))
Address: (permanent)
City/State/ZIP: (permanent)
Telephone: (Day)
Telephone: (Night)
Are you at least 18 years of age?		Yes No
Will you accept part-time employment?		Yes No
Will you accept seasonal employment?		Yes No
If yes, from:
to:
Have you ever applied for employment with us before?		Yes No
If yes, month and year
Do you hold a valid Security Guard Registration Card?		Yes No
Expiration:
Card #:
State:
List all valid First Aid and/or emergency care certificates you currently hold, with expiration dates:
First Aid
Advanced First Aid
CPR
EMT
Besides convictions for marijuana-related offenses that are more than two years old, have you ever been convicted of an offense other than a minor traffic violation?  If yes, describe:		Yes No
Answering "yes" does not constitute an automatic bar to employment. the nature of the offense, The date of the offense, the surrounding circumstances and the relevance of the offense to the positions (s) applied for will be considered.  Please exclude convictions which were sealed, expunged or statutorily eradicated, and any misdemeanor for which probation was successfully completed or otherwise discharged and the case has been judicially dismissed.
Are you currently under arrest pending trial?		Yes No
If yes, describe how it will affect your availability for work, if at all.
Are you able to perform the essential tasks and duties of the position you are applying for with or without reasonable accommodation?		Yes No
If no, please describe the duties and tasks that cannot be performed.

Education
List below any job related education including trade/technical training.

Employment History
List below all present and past employment starting with your most recent employer. (last 10 years is sufficient)

Business or Personal References
List persons who have first-hand knowledge of your work performance within the last three years.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby authorize CLM Services Corporation to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize my former employers to disclose to the company any and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

I understand that nothing contained in the application or conveyed during any interview which may be granted is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by me and the company's designated representative.

Confirm with your initials:

In the position you are applying for required that you drive a motor vehicle, please list your drivers license number and state.

Driver's license #: State issued:

Supplemental Questionnaire

Campground Staff

1. Do you have a late model RV, or Travel Trailer?  If so, please describe.
    If not, how are you planning to maintain a residence?

2. Are you limited in the hours you can work?  If yes, please explain.

3. What interests you in this type of work?

4. A significant part of your job will include cleaning toilets?
    Do you any objects to performing that type of work?

5. What are your interests in working with the public?

6. Please list any additional information which will help us assess your qualifications.