Employment Application
Regular (Full-Time / Year-Round) Summer (4-6 mos.) Fill-In Temp (As needed)
Teams you are applying for in order of preference (enter numerical value): Office/Guest Reception Kitchen Housekeeping Maintenance Systems Construction Healing Arts (OR massage License required) Admin Marketing/Events Guest Hosting/Security Childcare
How soon can you start?
Please list and explain detailed skills and work experience directly related to each individual team you are applying for.
What other skills do you have that you would be willing to share? (i.e. Yoga, Meditation, Singing, etc.)
List your certifications and degrees. (i.e. CPR, First Aid, Oregon LMT, Food Handlers, B.A., M.A. etc.)
From:
To:
Employer Name:
Phone:
Supervisor:
Position & Duties:
Reason for leaving:
We prefer email addresses to telephone numbers.
May we contact your previous employers? Yes No
If applying for a regular position, will there be any family, partner or pets that will live with you? (Dogs are not allowed because we are a wildlife sanctuary and the number of cats on property is limited.)
Will they live with you Full-time or Part-Time? Full-time Part-time
What do you consider to be your strong points that qualify you for this work?
Describe your ideas and/or experience related to Intentional Community and/or Cooperative living.
Name
Phone
Relationship
Years known
Have you ever been convicted of a misdemeanor or felony? Yes No If yes, please explain.
Will visa or immigration status prevent lawful employment? Yes No (Documentation proving legal right to work in the United States will be required upon hiring)
Is there anything that will interfere with your ability to perform, on a regular basis, the essential duties of the job you are applying for? Yes No If yes, please explain.
I certify all statements to be true and correct and authorize the investigation of information contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. I authorize Breitenbush Hot Springs to conduct a Criminal Background Check on the information provided in this application. Affixing my name to this electronic form is considered my legal signature.
Applicant Signature
Date
Breitenbush Hot Springs is an equal opportunity employer and does not discriminate on the basis of race, sex, age, color, religion, national origin, marital status, veteran status or any other basis prohibited by federal, state ot local law.