Forms • Fraser, CO • CivicEngage

Last Name*

First*

Middle Initial

Date*

Street Address*

Post Office Box*

City*

State*

Zip*

Phone*

Email*

Job Appling for*

Date Available*

Are you Seeking?

	Full-Time
	Part-Time

Seasonal

If hired, can you furnish proof that you are eligible to work in the U.S.*

Yes

No

Are you 18 years of age or older?*

yes

no

Have you ever been employed by the Town?*

Yes

No

Have you ever been convicted of a felony?*

Yes

No

If employed, do you expect to be engaged in any additional business or employment outside of your job?*

yes

no

If you will be engaged in additional business please explain*

* indicates required fields.