Please Provide the following:

  1. Personal Information

    Last Name

    Middle Name

    First Name

    Street

    City

    State

    Zip Code

    Telephone

    Alt. Telephone

    Email Address
    If you have resided at your present address for less than three years, list your prior address:

    Street

    City

    State

    Zip Code

    Position Desired

    Salary Expected
    List days of the week you are available to work:
    On what date would you be available to work?  
    (mm/dd/yyyy)
    Are you on a lay-off and subject to recall?
    Have you filed an application here before?
    Have you ever been employed here before?
    Do you have any relatives and/or acquaintances who are employed here?
    If yes, please list them by name:
    Why did you apply for this position at the Indianapolis Zoo?
    Why do you think you will make a valuable employee for the Indianapolis Zoo?
    Are you legally authorized to work in the United States?
    Are you 18 years of age or older?
    Have you ever been convicted of or pleaded guilty to a felony or misdemeanor other than a minor traffic violation?
    If yes, please explain:
    Have you ever been accused of a crime, or been the subject of an investigation, regarding child protection and safety, including (but not limited to) child abuse, neglect or sexual abuse? (Answering affirmatively to this question man not exclude you from employment with the Indianapolis Zoo, but the Indianapolis Zoo needs truthful and accurate information in response to this question in order to fully evaluate your employment application.)
    If so, please explain the circumstances and the outcome: 
    Name of person we should notify in case of emergency:
    Emergency Address:   Emergency Phone #  
  2. Education
    Type Of School Name Of School City,State Number of
    Years Completed
    Graduate Course Pursued / Degrees Granted
    Grade School
    Junior High School
    Senior High School
    College/University
    Business, Trade,
    or Technical School
    or College
    Correspondence
    or Special School
    or College
  3. Related Job Skills and References
    Summarize special job-related skills and qualifications acquired from education, employment, volunteer work, or military service.>

    List specific skills or office machines, tools, machinery, or other equipment on which you are trained and can operate that will be helpful in performing the responsibilities of the positions(s) for which you are applying.

    Professional References
    1.
    name

    address

    telephone
    2.
    name

    address

    telephone
    3.
    name

    address

    telephone
  4. Employment Record
    Attach Resume:
    Additional Documents:


    Employer
       to
    Employment Dates

    Kind of work performed

    Employer Address

    Telephone

    Starting Salary/Hourly Rate

    Ending Salary/Hourly Rate

    Job Title

    Immediate Supervisor

    Employer
       to
    Employment Dates

    Kind of work performed

    Employer Address

    Telephone

    Starting Salary/Hourly Rate

    Ending Salary/Hourly Rate

    Job Title

    Immediate Supervisor

    Employer
       to
    Employment Dates

    Kind of work performed

    Employer Address

    Telephone

    Starting Salary/Hourly Rate

    Ending Salary/Hourly Rate

    Job Title

    Immediate Supervisor
    May we contact the employers listed above?
    If no, please indicate which one(s) you do NOT wish us to contact, and state the reason why you prefer that we do not contact the employer(s).
    Have you ever been discharged or asked to resign from any position?
    If yes, please state the employer and dates of employment
    Which of the previous positions did you like best? Why?  
    Which of the previous positions did you like least? Why?  
  5. Applicant's Statement
      I certify that this application was completed by me and that all entries and information in it are TRUE and COMPLETE to the best of my knowledge. I understand that false, misleading, or omitted information in my application may result in the rejection of my application, the revocation of an offer of employment or discharge.

      I understand that an investigation may be made and information may be obtained through interviews with personal references and past employers, through a credit check, a criminal history check and/or driver’s record check. This inquiry may include information as to, among other things, my character, general reputation and personal characteristics, as well as information about my work performance and workplace conduct. I consent to this investigation and to the consideration of any statements of references, former employers or others that are given in response to the inquiry. If the Zoo decides to obtain a consumer credit report, I understand that the Zoo will provide, at my request, the name and address of the reporting agency so I may obtain from such reporting agency the nature and substance of information contained in such report.

      I hereby release all parties, including but not limited to the Indianapolis Zoo, professional references and previous employers from any and all liability for any injury or damage that may result from their furnishing information to the Indianapolis Zoo concerning me or any action the Indianapolis Zoo takes on the basis of such information.

      I understand that if I am offered a job as a condition of beginning my employment, I may be required to undergo a physical examination and/or drug screen; and I hereby authorize any doctor, hospital, clinic, laboratory or other medical facility to furnish any medical information with reference to me as may be necessary in conjunction with that examination and related considerations.

      I understand that, according to federal law, all individuals who are hired must, as a condition of employment, produce certain documentation to verify their identity and United States citizen status or, if aliens, their legal authorization to work in the United States. As a consequence, I understand that any offer of employment to me by the Indianapolis Zoo is contingent upon my ability to produce the required documentation within the time period required by law.

      I understand that this application is not, and is not intended to be, a contract of employment and that any resulting employment relationship is for no fixed period of time and is terminable at any time and for any reason by the Indianapolis Zoo or by me. I further understand that statements which may be contained in policies, practices, handbooks, or other material do not create any guarantee or contract of employment and the Indianapolis Zoo has the right to modify, amend, or terminate policies, practices, benefit plans, or other programs within the limits and requirements imposed by law. I understand that no representative of the Indianapolis Zoo, other than the President/CEO, has the authority to enter into any agreement for any specific periods of time or to make any agreement contrary to the foregoing and that any such agreement must be in writing to be binding on the Indianapolis Zoo.

      I understand that if I am offered employment, I will sign an agreement relating to confidential information, if required.

      I certify that I am not bound by any employment contract or non-competition agreement that would be breached by any employment that might be offered to me by the Zoo, nor am I in possession of nor will I at any time reveal to the Zoo, under any circumstances, any proprietary or confidential information that is the subject of any contract, non-disclosure agreement or prior work relationship involving any other person or entity.