Part Three

Columbia Gorge Center

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Application Part Three

Skills, Experience, and Qualifications
List potentially valuable skills, experience, or qualifications.
References
List your professional references (other than former employers or relatives).
Name
Telephone Number
Address
Occupation
Length of Time Known
Name
Telephone Number
Address
Occupation
Length of Time Known
Name
Telephone Number
Address
Occupation
Length of Time Known
Please Read and Understand the Following Statement Before Submitting the Rest of Your Application:
The information I have provided in this Application for Employment is true, correct, and complete. False, incomplete, or misrepresented information of any kind will be sufficient cause for my application to be rejected or, if discovered after I am employed, will be cause for immediate termination of my employment. I authorize Columbia Gorge Center to contact and obtain information about me from previous employers, educational institutions and references I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, related employment resume, or personal interview. To assist in the processing of my application, I waive all rights and claims I may otherwise have against Columbia Gorge Center or its representatives for seeking and using information to evaluate my employment request and all other persons, corporations, or organizations who provide information for this purpose. This application will expire in 30 days from the date submitted. After that date, unless otherwise notified, my status as an applicant will end. I may reapply for employment in the future by completing a new application. This application is not an employment agreement. If I accept an offer of employment I understand the employer may terminate my employment at any time, with or without cause and without prior notice unless required by law. I understand that no manger or representative of Columbia Gorge Center, other than the Board of Directors, has authority to enter into agreement for any specified period of time or to make any agreement contrary to the foregoing, and such agreement must be in writing. Management will make an effort to accommodate individual preferences. However, business needs may make the following conditions mandatory: overtime, shift work, a rotating work schedule, or a work schedule other than Monday through Friday. I understand and accept these as conditions of my continuing employment. Yes or No Applicant's Name Date
Employment Reference Check
Supervisors must list a minimum of three employment references contacted. If applicant has fewer than three former employers, contact professional references.
Employer
Telephone Number
Contact Date
Individual Providing Reference
Relationship to Applicant
Results
Employer
Telephone Number
Contact Date
Individual Providing Reference
Relationship to Applicant
Results
Employer
Telephone Number
Contact Date
Individual Providing Reference
Relationship to Applicant
Results
Employer
Telephone Number
Contact Date
Individual Providing Reference
Relationship to Applicant
Results