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11 Office Use Only: Seasonal 2014 POSITION APPLIED FOR: 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--- Please check the jobs you would be most interested in performing if you were hired by the City of Cody. If there are any that are of particular interest, please mark them with a star In the comments section below, please note any specific experience you have with each job. Please indicate if you would like to be considered in a pool of applicants for positions with the City of Cody on a year-round basis. If you mark yes, then the City of Cody will keep your application active for one year and consider your application for a variety of jobs that become available throughout the year. Yes No Parks & Public Facilities _____Mowing with push or riding mower _____Watering _____Weeding _____Planting flowers, trees, shrubs _____Pruning flowers, trees, shrubs _____Trimming with hand held trimmer _____Roto-tilling _____Raking _____Ballfield maintenance _____Cleaning outdoor restrooms, picnic tables, grills, picking up trash, etc. _____Concrete work _____Building _____Roofing _____Painting _____Operating hand and power tools _____Cleaning inside restrooms _____Dusting _____Washing windows _____Vacuuming _____Mopping _____Event set up and tear down Streets _____*Operate heavy equipment and/or trucks *Indicate what you can safely operate: _____Flagging _____Repair and maintenance of streets. Water/Wastewater _____Interacting and communicating with and educating the public on regulations, policies or ordinances _____Serve as a safety assistant when working around sewer manholes and water pits _____Obtain training in confined space rules and regulations Aquatics _____Instruct swimming lessons and other special aquatic programs _____Lifeguard _____Instruct aquatic aerobic programs _____Instruct American Red Cross Certification Programs _____Chemical balancing and maintenance of pool, spas, etc. _____Administer First Aid/CPR Recreation _____Gymnastics _____Tennis _____Basketball _____Volleyball _____Soccer _____Pre-school Activities Camp or Summer Camp Activities _____Arts and Crafts _____Cooking _____Drive bus for youth activities _____Weight, Cardiovascular and Aerobics Training Other _____Operate Concession Stand _____Handle money _____Prepare food _____Filing _____Answer phones _____Greet customers _____Type _____Write reports and document findings _____Interact with public _____Capture loose animals _____Respond to citizen complaints and concerns. Comments: ---PAGE BREAK--- To provide your driving record (State of WY) at no cost to you complete Section B Date, sign and return with application - Record will only be obtained if required for position applying for X City of Cody C Baker PO Box 2200 Cody WY 82414 [PHONE REDACTED] [PHONE REDACTED] X ---PAGE BREAK--- City of Cody Temporary and Provisional Positions - Not to Exceed 1039 Hours 10 year driving record requirement - Applicants applying for position(s) requiring a driving record – may either obtain at their cost the 10 year driving record or complete section of the Release for Driving Record. Note: by authorizing the City of Cody to obtain your driving record will result in delay of the application process up to 14 days. Parks & Public Facilities Divisions Job Title Rate of Pay Maintenance Worker I $8.60 Maintenance Worker II $9.14 Maintenance Worker I: Irrigation Maintenance Worker Assists with the repair and replacement of underground irrigation lines and sprinklers. Landscape Maintenance Worker Assist with watering, planting, weeding, and minor pruning of trees, shrubs, and flowers, maintaining tree wells, shrub and flower beds. Employee may also treat trees, shrubs, flowers or other foliage with spray herbicide. Park Mowers Responsibilities include using riding power mowers to cut grass on all city property. May assist other City divisions as assigned. Must be 18 years of age or older and have a valid driver’s license. These positions may require a varied schedule including evenings, holidays and weekends. Must submit a Driving History Record with application. Maintenance Worker II: Playground Inspector Employees will inspect playground equipment, and if necessary make repairs and document repairs of faulty equipment. Must roto-till and rake sand areas on a basis. Park Trimmer General maintenance duties include operating power and push mowers and motorized weed trimmers to cut grass and weeds around trees, facilities and equipment; including the Greybull Hill and 13 th Street Hill parkways and various other grass areas within the City. Ball Field Maintenance Workers Duties include the maintenance of the City’s three softball fields, five baseball fields and the maintenance and cleanliness of the ball fields. Must be able to drive maintenance vehicles and various equipment including mowers, sand-pro and tractor to perform various functions in the ball fields. Carpenter Helper Must assist with construction projects including concrete work, roofing projects, painting and other various projects. Must have basic carpentry skills and willingness to learn construction procedures. These positions may require a varied schedule including evenings, holidays and weekends Park Attendant Employee must be able to work a schedule that accommodates the opening and closing of City parks and must be able to clean restrooms, wash picnic tables, clean fire grills, empty garbage receptacles, pick up garbage and provide general cleaning and maintenance of all park grounds. Employee must interact with the public as necessary. Employees are required to work rotating shifts and will work weekends, evenings, early mornings and holidays throughout the summer. May assist other City divisions as assigned. Must be 18 years of age or older and have a valid driver’s license. Must submit a Driving History Record with application. Public Works Division Job Title Rate of Pay Public Works Maintenance Worker I $9.68 Public Works Maintenance Worker II (w/CDL) $10.75 Public Works Maintenance Worker I & II: General duties of the Public Works Maintenance Worker I and II positions include a variety of duties. In the Streets Division, employees will operate appropriate equipment, trucks and tools used in construction, repair and maintenance of streets and other City property. Employee will assist in the light maintenance of equipment, trucks and tools. Employee will assist with traffic control, remove debris from streets, parking lots and bike paths and will assist with street ---PAGE BREAK--- sign repair and replacement. Employees hired to perform duties requiring a Commercial Driver’s License (CDL) will be required to be part of the Wyoming Department of Transportation Drug and Alcohol testing process. This position may require a varied schedule including evenings, holidays and weekends. May assist other City divisions as assigned. Must be 18 years of age or older and have a valid driver’s license. Must submit a Driving History Record with application. In the Wastewater Division, employee will assist the Collection Systems Operator in routine maintenance and cleaning of the sanitary sewer collection system. Also assists with Confined Space Entry and TV work as needed. May assist other City divisions as assigned. Must be 18 years of age or older and have a valid driver’s license. Must submit a Driving History Record with application. Aquatics Division Job Title Rate of Pay Aquatics I $8.06 Aquatics II $8.60 Aquatics III $9.68 Aquatics IV $13.00 Party Coordinator $9.14 Aquatics Fitness/Aerobics Instructor $10.21 Aquatics I: Duties include serving as an aide during swimming lessons, dispatching patrons down the water slide, acting as a shallow water attendant, interacting with the public and assisting with custodial duties. Employee must be willing to communicate clearly and concisely with the public of all ages. Employees must be certified through the American Red Cross in CPR and First Aid (preferably Professional Rescuer) and attend an in-house Water Safety Instructor Aide class. Employees must be at least 14 year of age and available to work approximately 10-40 hours per week depending upon the season including evenings, weekends, and holidays. May assist other City divisions as assigned. Aquatics II: Employees must be certified through the American Red Cross as either a Lifeguard or Water Safety Instructor and be certified in CPR (preferably Professional Rescuer). Employee may be certified as both Lifeguard and Water Safety Instructor; however, the employee will primarily be employed to serve as one or the other. Water Safety Instructor’s must be at least 16 years of age and duties include planning, instructing and evaluating the American Red Cross Learn to Swim program. Employee must be able to assess swimming skills for various levels and determine appropriate instruction. Lifeguards must be at least 15 years of age and duties include patron safety, recognizing unsafe conditions, implementation of safety protocol, and emergency response. Employees will assist with custodial duties and water testing and maintenance. Employees must be able to communicate clearly and concisely with patrons of all ages. Employees are expected to demonstrate a high level of professionalism, maturity and responsibility. Participation in training and frequent skills review is mandatory. Employees should expect to work approximately 10-40 hours per week depending on the season including evenings, weekends and holidays. May assist other City divisions as assigned. Aquatics III: Employees must be certified through the American Red Cross as both a Lifeguard and a Water Safety Instructor and serve in both capacities on a regular basis. Duties of the Aquatics II apply to the Aquatics III position. Employees should expect to work approximately 10-40 hours per week depending on the season including evenings, weekends and holidays. Duties will be assigned based on qualifications and department needs. May assist other City divisions as assigned. Aquatics IV: Employees must be certified through the American Red Cross as Lifeguard and serve in this capacity on a regular basis. Duties of the Aquatics II apply to the Aquatics IV position. Employees should expect to work approximately 10-40 hours per week depending on the season including evenings, weekends and holidays. Will perform as “shift supervisor” and be responsible for assigned staff during shift, implementation of shift duties/responsibilities, review daily and weekly maintenance logs. Review ---PAGE BREAK--- timesheets at the end of each day. Assist in performing duties associated with closure of pool area. Duties will be assigned based on qualifications and department needs. May assist other City divisions as assigned. Aquatic Fitness/Aerobics Instructor: Employees will instruct a variety of ongoing and new programs including water aerobics, and other strength/cardiovascular training. The primary duties include designing and teaching fitness/aerobic classes to seniors, adults and youth including physical activities, special interest classes and special events. Applications will be taken on an ongoing basis and positions will be filled as needed. Actual open position(s) dependent upon seasonal classes being offered. The City of Cody will maintain applications to review throughout the year as positions become available Party Coordinator: Employee will coordinate and make necessary arrangements for party packages at the Recreation and Aquatics Facility. The primary duties include coordinating parties, ordering and picking up requested food in advance of party, create requested Birthday sign, and organize and lead aquatic or recreation activities. Responsible for all set up, take down and clean up requirements of room or facility used for such party. Provide signup sheet for participants upon arrival, provide lifejackets for non swimmers if applicable and explain pool rules and policies to participants. Take pictures of the party participants and activities, downloads and prints off for participants. Computer skills, organization skills, ability to work with a variety of children of all ages, basic swimming skills/knowledge needed. Required to use over for food preparation. Must be 18 years of age or older and have a valid driver’s license. Recreation Division Job Title Rate of Pay Recreation Assistant I $8.60 Recreation Assistant II $9.14 Fitness/Aerobics Instructor $10.21 Recreation Assistant I: Employee will help Recreation Staff coordinate and supervise a variety of recreational activities for children of all ages including tennis, gymnastics, volleyball, basketball, soccer, gymnastics, day camp, arts and crafts and a variety of other programs. In addition, employee may serve as a facility monitor at the Recreation Center. Duties include monitoring the activities in the gymnasium and workout area as well as cleaning weight and cardiovascular fitness equipment and setting up and taking down equipment for league games. Employee may also serve as a concession stand attendant, preparing and serving food and snacks, stocking shelves, monitoring inventory and cash handling. Employee should expect to work approximately 10-35 hours per week depending on the season including evenings, weekends and holidays. Must be at least 14 years of age. May assist other City divisions as assigned. Recreation Assistant II: Employee will assist Regular Part-time Recreation Assistants with the coordination and supervision of the Kidz on the Move Daycamp as well as the After School Activities Program when in session. Employee may also serve as a facility monitor at the Recreation Center. Duties include monitoring the activities within the facility as well as cleaning weight and cardiovascular equipment and setting up and taking down of equipment for league games and special events. Employee may also serve as a concession stand attendant, preparing and serving food and snacks, stocking shelves, monitoring inventory and cash handling. Employee may also answer phones, meet and greet patrons, swipe membership cards check patrons into facility, take registrations for programs, make facility reservations, and handle cash drawer and daily balancing of drawer and file. Employee should expect to work approximately 10-35 hours per week depending on the season including evenings, weekends and holidays. Must be at least 14 years of age. May assist other City divisions as assigned. ---PAGE BREAK--- Fitness/Aerobics Instructor: Employees will instruct a variety of ongoing and new programs including yoga, step aerobics, spinning, Pilates, water aerobics, and other strength/cardiovascular training. The primary duties include designing and teaching fitness/aerobic classes to seniors, adults and youth including physical activities, special interest classes and special events. Applications will be taken on an ongoing basis and positions will be filled as needed. Certifications from organizations such as ACE and ACSM are desired. May assist other City divisions as assigned. Actual open position(s) dependent upon seasonal classes being offered. The City of Cody will maintain applications to review throughout the year as positions become available. Miniature Golf Course Job Title Rate of Pay Lead Attendant: $12.50 Attendant: $9.60 Lead Attendant: Employee will schedule and assign staff to facilitate daily operations of miniature golf course, as well as, oversee all operations including answering questions, maintaining cleanliness and properly maintained course. Provide superior levels of customer service to golf course customers, report for all scheduled shifts or find a substitute. Must be able to provide own transportation to work, able to work flexible hours, able to handle and count cash. A work schedule may fall anywhere between 11:00 am and 9:00 pm Sunday through Saturday, including holidays. Must be at least 18 years of age. Attendant: Work assigned shift to facilitate daily operations of miniature golf course, as well as, oversee all operations including answering questions, maintaining cleanliness and properly maintained course. Provide superior levels of customer service to golf course customers, report for all scheduled shifts or find a substitute. Must be able to provide own transportation to work, able to work flexible hours, able to handle and count cash. A work schedule may fall anywhere between 11:00 am and 9:00 pm Sunday through Saturday, including holidays. Must be at least 16 years of age. Transportation Bus Driver: $11.29 Bus Driver: Employee must have a Commercial Driver’s License with passenger endorsement This position duties require the employee to drive a bus for the After School Activities Program, Kidz on the Move Daycamp program and other recreation programs. When driving the bus for recreation programs, driver must assist with the activities when on-site and not engaged in driving the bus. Employee should expect to work approximately 10-40 hours per week between the hours of 7:30 a.m. and 6:00 p.m. throughout the week. Employees hired to perform bus driving duties will be required to be part of the Wyoming Department of Transportation Drug and Alcohol testing process. Weekend and holiday hours may apply. May assist other City divisions as assigned. Must submit a Driving History Record with application.