Recreation and Outdoor Activities in Portola Valley, a Unique Community

Ladera Recreation District 150 Andeta Way. Portola Valley. CA 94028 650-854-3242 
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APPLICATION FOR EMPLOYMENT

Position applying for :  
Firstname : Lastname :
Street address : City :
Zipcode : Email :
Home Phone : Cell :
I am a returning employee : Yes No
If yes, what was your position? :
Hourly rate at end of 2016? :
How many years have you been employed at Ladera? :
The minimum age for employment with the Ladera Recreation District is 14 years. (Some jobs have a higher age requirement. Please check with manager.)
If hired, can you furnish proof of age? Yes No

EDUCATION

Highest grade completed: Intermediate/High School Years of College


Intermediate School :
Name :
City :
Name : City :

CHARACTER REFERENCES (Not necessary if you are a returning employee)

List the names of three adults (other than relatives) who have known you more than a year. You may include school principals, athletic coaches, counselors, etc.

Name : Phone :
Name : Phone :
Name : Phone :

CERTIFICATIONS ( Proof of Certification is required) DATE EXPIRES
Drivers License : Standard First Aid :
Cardiopulmonary Resuscitation (CPR) :

LIFEGUARD TRAINING
Water Safety Iinstructor (WSI) :

WORK EXPERIENCE (Please list all experience that will be relevant to the position for which you are applying.)

AVAILABILITY
I AM AVAILABLE From (Date) : Until :
AFTER SCHOOL DAY-TIME WEEKNIGHTS WEEKENDS
SPRING SUMMER FALL WINTER

If at college, indicate date you will be back in the Bay Area and ready to work :


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CAMP COUNSELORS ONLY :Please check activities which you feel competent to organize and teach:
Art and Crafts
Games
Nature Study
Story telling
Plays/skits
Singing
Musical Instrument

Which qualities do you have that will help you as a camp counselor?

I CERTIFIY THAT THE INFORMATION I HAVE GIVEN HERE IS TRUE AND CORRECT.

Employment Application Form