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Global Resources for Environmental Education & Nature

518 State Hwy BB Saddlebrooke, MO 65630 417-587-3633 Fax:417-587-3622 [email protected] www.nationaltigersanctuary.org

APPLICATION (Please Print or Type)

Global Resources for Environmental Education and Nature d.b.a. National Tiger Sanctuary is an Equal Opportunity Employer and adheres to applicable laws prohibiting discrimination on the basis of race, age, color, religion, sex, national origin disability, Vietnam Era veteran and disabled veteran status or any other protected category or basis prohibited by Federal, State or Local Law.

Last First Middle  Address City State Zip

How long at this address? Home phone Cell phone

For insurance purposes, are you over E-mail 18?

Interested In: Start and End Date: Do you need housing? Full Time  Part Time  Can you work weekends? Can you work Holidays? Have you applied to NTS before? Yes  No  Yes  No  Yes  No  Please list days available and any known conflicts. Do you have friends or family working at NTS? Yes  No 

If you have friends or family working here- Have you worked for NTS before? Names: Yes  Dates: No

EMPLOYMENT VERIFICATION: Are you a citizen of the United States or are you otherwise authorized to be employed in the United States under the Immigration Reform and Control Act of 1968? Yes  No  Your legal status regarding your right to work in the U.S. will be subject to verification, and you will be required to present satisfactory documentary proof of employment authorization and identity to GREEN d.b.a. National Tiger Sanctuary before employment.

PROFESSIONAL REFRENCES (Do not list relatives)

Name/Address Occupation Daytime phone number

General Information: Have you ever been convicted of or pleaded guilty to any crimes (felonies, and misdemeanors including crimes committed during military service)? Yes  No  Have you ever been convicted of or pleaded guilty to any sex related or child abuse related offenses? Yes  No  Conviction of a crime or indictment will not necessarily disqualify you from employment.

If you answered yes to any of the above questions, please briefly describe the details indicating the date, nature and place of the offense and the sentence received.

Complete

Do you have a valid driver’s license? Yes  No  State: Driver’s License# Has your license ever been suspended? Yes  No  If yes, please explain: EDUCATION

School Attended (most recent first) Years Completed Diploma/ Degree/ Major

SKILLS: Please list any skills that are applicable to the position you are applying for, and/or that you may have, for instance foreign languages, computer skills, special training…

1. ______

2. ______

3. ______

4. ______

5. ______

EMPLOYMENT HISTORY Are you employed now? Yes  No  If yes, may we contact your present employer? Yes  No 

LIST ALL JOBS, MILITARY SERVICE, OR SELF EMPLOYMENT FOR THE LAST 10 YEARS STARTING WITH THE PRESENT. Employment history will still be needed even if resume has been submitted.

Name of employer: Type of Business:

Address:

Phone: Name of Supervisor and Title: May we contact them? Yes  No  From (MM/YYYY) To (MM/YYYY) Starting Pay: Last Job Title:

Ending Pay: Description of Responsibilities:

Reasons for leaving:

NameMay weof employer: contact them? Type of Business: Yes  No 

Address:

Phone: Name of Supervisor and Title: May we contact them? Yes  No 

From (MM/YYYY) To (MM/YYYY) Starting Pay: Last Job Title:

Ending Pay: Description of Responsibilities:

Reasons for leaving:

Name of employer: Type of Business: NameDescription of employer: of Responsibilities: Type of Business: Phone:FromReasons (MM/YYYY) for leaving: Name To (MM/YYYY) of Supervisor and Title: Starting Pay: MayLast Jobwe Title:contact them? Address: Ending Pay: Yes  No 

Volunteer Experience:

Name & Number of Contact:

Duties:

Intern Experience:

Name & Number of Contact:

Animal Experience:

Special Skills:

Do you have any allergies?

______

Have you ever had a tetanus shot? When? ______

Do you have any history of medical problems that we need to be aware of that would prohibit you from working?

______

Signature: Date: