Town of West Hartford - Department of Leisure Services
50 South Main Street, West Hartford, CT 06107
Veterans Memorial Ice Skating Rink
RECREATION PART-TIME APPLICATION
PLEASE TYPE OR PRINT DATE:
Position Applying For: Facility:
Name: Social Security #:
Address:
Home phone: College phone: Work phone:
Are you Under 16? Yes__________ No______________
EDUCATION
High School: Graduated: Yes____ No____
College: Graduated: Yes____ No____

List any scholastic honors, extra curricular activities, hobbies or special interests:

 
EMPLOYMENT HISTORY
1. Present Employer: Supervisor's Name:
Employer's Address: Phone #:
Position: Employment Dates: From_______To_______
Reason for Leaving:
2. Previous Employer: Supervisor's Name:
Employer's Address: Phone #:
Position: Employment Dates: From_______ To_______
Have you ever been fired from a job? Yes____ No____
If yes, please explain:
Please list references we have your permission to contact:


1.___________________________________________________________________________________

NAME
ADDRESS
PHONE

2.___________________________________________________________________________________
NAME
ADDRESS
PHONE

3.___________________________________________________________________________________
NAME
ADDRESS
PHONE

Availability and Abilities

Dates available:

Beginning______________Ending_______________

Days available: (circle one)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Times available:
             

Abilities: Please list previous experience in the following areas:

1. Skating

Excellent_________

Above Average_________

Average__________

Weak__________

2. Cashier

3. Supervisory

Certification:

Red Cross CPR/BLS Certificate or Equivalent? Yes_______ No________ Expiration Date___________

Red Cross First Aid Certificate or Equivalent? Yes________ No________ Expiration Date___________

List any skills or special training you have had:

 

Why are you applying for work at the Veterans Memorial Ice Skating Rink?

 

What benefits do you hope to gain from working at the Veterans Memorial Ice Skating Rink?

 

Any additional comments or pertinent information you wish to add?

 

I hereby certify the above information is true and correct.

______________________________________________

____________________________

Signature

Date

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