Roseville Fun Jump Member of AIRCO Moonwalk Rental Safety Association Member of Safe Kids Placer County
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RFJ Administration

January 2009
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Roseville Fun Jump Needs You

It is the policy of this company to provide equal employment opportunities to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, physical or mental handicap or veteran status.

Position Applying For:
PERSONAL INFORMATION
First Name:
 Middle Initial:
 Last Name:
Current Address:
Street and Apt.#:
 City:
 State:
 Zip Code:
Permanent Address (if different from above):
Street and Apt.#:
 City:
 State:
 Zip Code:
Telephone: Email:
Social Security #: Driver's License #: State:
I am a U.S. Citizen or otherwise authorized to work
in the United Stated on an unrestricted basis:
If applicable, please list your visa type, visa # and expiration:
Have you ever been convicted of a felony?
If you answered yes, please explain:
Have you ever served in the U.S. Military?
If you answered yes, please provide the following information:
Branch of Service:
Rank at time of separation:
I served from to
Special Honors:
EMPLOYMENT HISTORY
Present or Most Recent Employer
Employer: Address:
Your Position: Salary:
Dates of Employment:to
Duties:
Supervisor Name: Supervisor Title: May we contact?
Reasons for Leaving:
Prior Employer
Employer: Address:
Your Position: Salary:
Dates of Employment:to
Duties:
Supervisor Name: Supervisor Title: May we contact?
Reasons for Leaving:
Prior Employer
Employer: Address:
Your Position: Salary:
Dates of Employment:to
Duties:
Supervisor Name: Supervisor Title: May we contact?
Reasons for Leaving:
EDUCATION
High School
School Name: Address:
Did You Graduate?:
If you did not graduate,
did you receive your GED?:
Attended From:to
Special Honors or awards:
Technical or Vocational School
School Name: Address:
Did You Graduate?:
Attended From: to
Degree or Certification:
Specialty:
Special Honors or awards:
College or University
School Name: Address:
Did You Graduate?:
Attended From: to
Degree:
Major:
Special Honors or awards:
College or University
School Name: Address:
Did You Graduate?:
Attended From: to
Degree:
Major:
Special Honors or awards:
POSITION SPECIFICATIONS
How did you hear about this job?
What hours are you willing to work?
Are you able to work weekends?:
When would you be able to start?
Desired Salary? per
SKILLS
Please describe any computer skills?
Please describe any customer service skills?
Please describe any Languages Spoken (other than English)?
Other:

I hereby certify that my answers and assertions set forth in the application are true and complete to the best of my knowledge. If I am employed, I understand that any false statements on this application shall be considered sufficient cause for my dismissal. I herby authorize this company to investigate any aspect of my prior educational and employment history.

Furthermore I understand that if I am hired, employment with this company is "at will", which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.