First Name (required)
Middle Initial
Last Name (required)
Street Address (required)
City (required)
State (required)
Zip (required)
Phone Number (required)
Email Address (required)
Do you currently live with in 30 minutes of Clifton, CO? (required) Yes No
If "NO" are you planning on relocating to the area and if so when?
If you are related to any of our employees, please state the name of the employee and the employee's position, if known.
Are you lawfully authorized to work in the United States? (required) Yes No
Are you at least 18 years of age? (required) Yes No
Desired Wage
When will you be available for work? (required)
Do you have any commitments that will require you to be absent from work during regular work hours for more than three consecutive days within the next six months? (required) Yes No
If "YES" please explain
Have you been or will be laid off and subject to recall? (required) Yes No
Are you available for Full Time Work? (required) Yes No
Are you able to work more than 40 hours a week? (required) Yes No
Are you able to work nights, weekends, and holidays? (required) Yes No
If "NO" list days of the week and hours of the day you CAN'T work
Company Name (required)
Company Address (City and State) (required)
Phone # (required)
Start Date (Mo/Yr) to End Date (Mo/Yr) (required)
Position (required)
Duties (required)
Reason for Leaving (required)
Can we talk to your current employer now, or only if you are hired? (required) Yes Only if Hired
Company Name
Company Address (City and State)
Start Date (Mo/Yr) to End Date (Mo/Yr)
Position
Duties
Reason for Leaving
Can we contact this employer? Yes No
Company Name
Company Address (City and State)
Start Date (Mo/Yr) to End Date (Mo/Yr)
Position
Duties
Reason for Leaving
Company Name
Company Address (City and State)
Start Date (Mo/Yr) to End Date (Mo/Yr)
Position
Duties
Reason for Leaving
Company Name
Company Address (City and State)
Start Date (Mo/Yr) to End Date (Mo/Yr)
Position
Duties
Reason for Leaving
Upload Cover Letter
Upload Resume
Upload Additional Employment Information
Have you ever been employed by us before? (required) Yes No
If "YES" please state the positions held, period of employment and reason for leaving.
Explain any gaps in your work history that are longer than six months.
Have you ever been fired from a job or quit under threat of being fired? (required) Yes No
If "YES" when and who was the employer?
What reason did the employer give you for your dismissal or forced resignation?
Please describe any problems in your current job about which you have been warned or disciplined during the past 12 months:
Do you currently have a Water Treatment Operator Level A, B, C, or D, Certification? (required) Yes No
If "YES" what Level of Certification do you have? A B C D
If "NO" are you able to obtain your Level D Certification within the first 90 days of employment? Yes No
Do you meet the educational and experience qualifications of the position? (required) Yes No
If "NO" what qualifications do you lack?
I have reviewed the essential job functions and state that I can perform these functions with or without reasonable accommodation. (required) Yes No
High School Name: (required)
High School Diploma or GED (required) Yes No
College Name:
Degree Yes No
Major/Minor
If "YES" what type of degree?
Technical or Graduate School Name:
Major Subjects
Graduated? Yes No
Do you have any special training or skills that you believe are relevant to this position?
Within the past 60 days, have you used marijuana, cocaine, any narcotics, amphetamines, barbiturates, or other controlled substances that were not taken as prescribed to you by a physician? (required) Yes No
Name (First and Last)
Email Address
Phone Number
Relationship and Years Acquainted
Name (First and Last)
Email Address
Phone Number
Relationship and Years Acquainted:
Name (First and Last)
Email Address
Phone Number
Relationship and Years Acquainted:
Please state the employee's name if referred by a current employee.
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