Substitute Crossing Guard Application

Farr West City is accepting applications for substitute crossing guards. Please complete all applicable questions.

Contact Information and References

Application Date

Select date

Primary Phone

(555) 555-5555

Full Legal Name

Your answer

Professional References

Your answer

List professional references. For each reference, include full name, employer or position, business address, and business phone number.

Mailing Address

123 Main Street

Email Address

example@example.com

Personal Information and Availability

Date Available to Begin Work

Select date

Do you have a valid Utah driver's license?

e.g., 11:30 p.m.

Are you a U.S. citizen?

e.g., 5:00 a.m.

List any other names used

Your answer

Availability *

Early Mornings

Afternoons

Do you have any relatives working for Farr West City? If yes, list their name.

Your answer

Education, Training, and Employment History

Education and Training

Your answer

List each high school, college or university, trade school, or special training program. Include the school name, city and state, major or degree, number of years attended, degree or diploma earned, and graduation year.

Employment History - Present or Most Recent Employer

Your answer

Include employer name, telephone number, address, employment dates (MM/YYYY), supervisor name and title, job title, starting and ending earnings, reason for leaving, and a description of your work.

Employment History - Previous Employer 1

Your answer

Include employer name, telephone number, address, employment dates (MM/YYYY), supervisor name and title, job title, starting and ending earnings, reason for leaving, and a description of your work.

Employment History - Previous Employer 2

Your answer

Include employer name, telephone number, address, employment dates (MM/YYYY), supervisor name and title, job title, starting and ending earnings, reason for leaving, and a description of your work.

Employment History - Previous Employer 3

Your answer

Include employer name, telephone number, address, employment dates (MM/YYYY), supervisor name and title, job title, starting and ending earnings, reason for leaving, and a description of your work.

Have you ever been employed by Farr West City?

Select one

Applicant Certification

Applicant Signature *

Signature Date

Select date

Certification Acknowledgment *

I certify and agree to the statement above.

I certify that all statements made in this application and its attachments are true and complete. I understand that any material misstatement may result in disqualification or termination. I authorize Farr West City to obtain criminal and other job-related information and authorize previous employers to provide information regarding my work history. I understand that I may request to be informed of the contents and respond to findings I believe are incorrect.