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11 POSITION APPLIED FOR: RPT Recreation Assistant $12.72/hr Date: Employment Application City of Cody P.O. Box 2200 ~ Cody, WY 82414 Name Last First Middle Street/Mailing Address: City St Zip Email Address: Work Phone: Home Phone: Cell Phone: List other names, if any, used on employment or education records: Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? □ Yes □ No Are you 18 yrs or older? □ Yes □ No Are you under the age of 14? □ Yes □ No For Temporary/Seasonal Hire – Please complete the following. Dates Available for Employment: From to Have you ever been convicted of a felony? □ Yes □ No If yes, describe in full detail, giving dates (Criminal convictions are not an absolute bar to employment, but will be considered in relation to specific job requirements.) Have you ever worked for or are you currently working for the City of Cody? □ Yes □ No If yes, please give dates and department(s): Prior Position(s): Reason(s) for leaving: Do you have any relatives working for the City of Cody? □ Yes □ No If yes, please give their name, department and relationship: P E R S O N A L I N F O R M A T I O N ---PAGE BREAK--- E D U C A T I O N School Name and Address of School Course Circle Last Year Did You List Diploma Of Study Completed Graduate or Degree(s) High 8 9 10 11 12 □ Yes □ No College 1 2 3 4 □ Yes □ No Other (Specify) S P E C I A L S K I L L S Special Skills Relating To The Position For Which You Are Applying: (clerical skills, heavy equipment operating skills, etc.) C E R T I F I C A T I O N S Driver’s License: If required for this position: Do you have a valid Driver’s License? □ Yes □ No State: License Number: Expiration Date: Do you have a Commercial Driver’s License? □Yes □ No If yes, specify: Class: B, C) Endorsements Held: Hazardous Material □ Tanker □ Airbrakes □ Passenger □ (Please check all that apply) Other (specify) Certificates: (CPA, PE, Boiler Operator, Life guard, etc) Name and address of Licensing Agency Type of License Endorsement/Restriction (if applicable) Date Licensed Date Expires (if applicable) ---PAGE BREAK--- E M P L O Y M E N T H I S T O R Y Employment Experience Instructions: Begin with your present or most recent job and list your entire work experience with emphasis on experience relevant to the position for which you are applying. Include military service and any volunteer work which provided experience that would help you qualify. If the space below is not adequate, you may continue this section on a separate sheet of paper. This information must be completed. Notice to Applicants: Information that you provide on this application is subject to verification. Previous employers may be contacted as references or for verification. Do you want to be informed before we contact your present employer? □ Yes □ No Current Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: AUTHORIZATION TO RELEASE INFORMATION I certify that all information provided in this application is true and complete. I understand misrepresentation or omission of facts during the application or selection process may disqualify me from further consideration and may be cause for dismissal. I understand the City of Cody may conduct a background investigation, which may include obtaining information as to my character, reputation, and mode of living. This may include interviews with my relatives, neighbors, friends, former employers, schools and others. I understand I have the right to make a written request within a reasonable time for the disclosure of the name and address of any consumer reporting agency which may be utilized in the background investigation so I may obtain a complete disclosure of the nature and scope of the investigation. I authorize the investigation of any or all statements contained in this application and also authorize any person, school, current employer (except as previously noted), past employers and organizations named in this application to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements. I understand that if I am extended an offer of employment it may be conditioned upon my successfully passing a complete pre- employment physical examination. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying. I understand that I may also be required to successfully pass drug and alcohol screening examinations. I hereby consent to pre- and/or post-employment drug and alcohol screens as a condition of employment, if required. I have read, understand, and by my signature, consent to these statements. I authorize investigation of all information contained in this application. Signature of Applicant Date (Revised 2013) References: List three references, excluding relatives, who have knowledge of your ability to perform this job. Name of Reference Complete Mailing Address Telephone Number Years Acquainted ---PAGE BREAK--- Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: Past Employer: Mailing Address: Street Address: Date Employed: From Salary/Wage: Position(s) Held: Contact Name and Title: Phone Description of work performed: Reason for leaving: ---PAGE BREAK--- City of Cody Job Description Title: RPT Recreation Assistant Code: 270 Department: Parks/Recreation & Public Facilities Effective Date: 03/2007 Division: Recreation Last Revised: GENERAL PURPOSE Performs a variety of routine administrative duties related to planning, organizing and teaching toddlers, youth, teens, adults and elderly recreation programs including cultural arts, physical activities, special interest classes and summer programs. SUPERVISION RECEIVED Works under general supervision of the Recreation Supervisor. SUPERVISION EXERCISED None. ESSENTIAL FUNCTIONS Co-teaches students participating in after school programs; plans and implements appropriate recreational activities and participates or instructs children in games; ensures the safety and well being of each participant while participating in recreation sponsored programs or being cared for in city facilities. Assists in the development, scheduling and implementation of recreations programs for all ages by coordinating and instructing classes, workshops and activities; assists in the development of summer day camp programs and field trips. Works with outside agencies in the development and implementation of a model after school program; Responds to public inquiries about recreation programs made by telephone, correspondence, or during public meetings as assigned, and reports inquiries to appropriate staff member as necessary. Assists in preparing a variety of brochures, calendars, letters, posters, news releases, flyers and related communications regarding recreation programs. Maintains a variety of records, including registration attendance, permission slips, purchasing receipts, accident/incident reports, and vandalism. Maintains supplies and replenishes as needed or notifies the proper staff when supplies are low and need to be replenished. Attends and participates in staff development functions such as in-service training; assists in the training of new staff related to concession operations, recreation center operations policies, practices and procedures, behavior management and safety regulations. Promotes interest and maintains open and positive communications with community and private organizations. ---PAGE BREAK--- Performs a variety of miscellaneous duties such as answering phones, typing correspondence, running errands, picking up supplies needed for activities, conducting recreation activities for children, helping set up for events, cleaning up after events ensuring a clean and safe environment for participants and other duties as assigned. Participates in the recreation complex preventative maintenance program in conjunction with other staff members. Performs related duties as required. MINIMUM QUALIFICATIONS 1. Education and Experience: A. Graduation from high school or G.E.D.; plus six months of relevant experience in child care and/or recreation programming/instructing setting OR B. An equivalent combination of education and experience. 2. Knowledge, Skills, and Abilities: Some knowledge of child growth and development; methods and techniques of developing and operating city recreation and community education programs; various recreation activities which target all segments of the community from youth to senior citizen; general office maintenance and practices; interpersonal communication skills; public relations. Skill in the art of diplomacy, cooperative problem solving, developing complex presentations and public speaking before small audiences. Ability to supervise daily work programs; read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; write routine reports and correspondence; speak effectively before groups of Recreation Center members, employees or the general public, and children; solve practical problems and deal with a variety of information in situations where only limited standardization exists; interpret and apply a variety of instructions furnished in written, oral, diagram, or schedule form; calculate figures and amounts such as discounts, interest, proportions, percentages; establish and maintain effective working relationships with employees, community organizations, and the public. 3. Special Qualifications: Must possess and maintain a valid Wyoming Class C Driver’s License. Must be or become within three months of employment Infant/Child or Community CPR/1st Aid certified. 4. Work Environment: Tasks require a variety of physical activities not generally involving muscular strain. Physical demands may occur in activities related to walking, standing, stooping, sitting, reaching, etc. Talking, hearing and seeing required in the daily performance of job duties. Worker must regularly lift and/or move up to 10 pounds, frequently lift and/or move up to 25 pounds, and occasionally lift and/or move up to 50 pounds. Occasional exposure to environmental hazards and outside weather conditions. The employee is occasionally exposed to moving mechanical parts, toxic or caustic chemicals, and risk of electrical shock. Mental application utilizes memory for details, emotional stability and discriminating thinking and creative problem solving. Periodic travel required in course of performing portions of job functions.