Application for Employment

Range Development Company (RDC), is an equal opportunity employer. Our objective
is to maintain a continuing policy of non-discrimination in employment. You will be considered
for employment based upon your qualifications for the position for which you are applying.

Position Applying For
General Information
**First name:
 		Middle name:
 		**Last name:
** Social Security Number (Enter numbers only) :
  
**Address:
 		**Address 2:
**City:
**State:**Zip:
**County:
At least one of the following method of communication is required.
Please mark preferred method of communication in the box next to that type.




   
Yes No **Are you under the age of 18?
Yes No **Have you ever filled an application with us previously?
Yes No **Have you ever been employed by Hillcrest? If yes, provide dates of employment. (70)
Yes No **Do you have a valid driver's license? (A valid driver's license is a job-related requirement of some positions at Hillcrest.)
Yes No **Are you legally eligible to work in the United States? If employed, you will be required to provide employment eligibility verification mandated by the federal government.
Yes No **Will you now or in the future require sponsorship for employment visa status (e.g., H-1B visa status)? We do not currently sponsor temporary work visa holders.
Yes No Are you available for shift work?
Yes No Are you available for overtime work?
Yes No Are you currently on a "lay-off" status and subject to recall?
Yes No Can you travel if the job requires it?
Yes No Have you been convicted of a felony in the past 7 years?
If yes, explain
 
Employment History
Provide the employment information requested below, including experience in the U.S. Military Service. Begin with your present or most recent employment. If you have more than three previous employers, you will be required to supply those during an interview.
 
Employer 1
Name
Address
City:
State: Zip:
Phone Number:
Type of Business:
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone:
Job Title:
Describe the work you did:

(300)
 
From:
Month: Year:
To:
Month: Year:
Reason for Leaving:
Employer 2
Name
Address
City:
State: Zip:
Phone Number:
Type of Business:
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone:
Job Title:
Describe the work you did:

(300)
 
From:
Month: Year:
To:
Month: Year:
Reason for Leaving:
Employer 3
Name
Address
City:
State: Zip:
Phone Number:
Type of Business:
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone:
Job Title:
Describe the work you did:

(300)
 
From:
Month: Year:
To:
Month: Year:
Reason for Leaving:
 
Yes No May we contact the employers listed above?
(If no, indicate below which employer(s) we should not contact.)

Employer 1         Employer 2         Employer 3
 
Education and Training
Indicate all schools that you have attended. Completion of a formal education is a job-related requirement for some positions at RDC.
High School
School Name

 (40)
 
City
State
Mark Last
Year Completed
9 10 11 12
Year Graduated (YYYY)
 
Vocational/Technical
School Name
 (40)
 
City
State
Mark Last
Year Completed
13 14
Diploma/Degree
Year Graduated
(YYYY)
Major:
Minor:
College/University
School Name
 (40)
 
City
State
Mark Last
Year Completed
Freshman Sophmore Junior Senior
Diploma/Degree
Year Graduated
(YYYY)
   
Major:
Minor:
Graduate School
School Name
 (40)
 
City
State
Mark Last
Year Completed
17 18 19 20
Diploma/Degree
Year Graduated
(YYYY)
   
Major:
Minor:
 
Other Post High
School Courses
Completed
(240)
 
 
Specialized Training, Certification and Skills:

List current keyboarding/transcription/10-key speed, computer literacy, skill certification, special licenses,
military training, etc., that you possess that pertain to the position for which you are applying.
(500)
Membership in Professional Organizations:
(Exclude those which may disclose your race, color, age, sex, religion or national origin.)
(200)
 
Indicate any foreign language you can speak, read and/or write:
  Fluent Good Fair
Speak
Read
Write
References, give name, address and telephone number of three references who are not related to you and are not previous employers:
Reference #1
Name:        
Address:        
Addres 2:        
City State Zip
Phone Cell EMail
Reference #2
Name:        
Address:        
Addres 2:        
City State Zip
Phone Cell EMail
Reference #3
Name:        
Address:        
Addres 2:        
City State Zip
Phone Cell EMail

Have you had any job-related training in the United States Army? Yes No 

If Yes Please Describe:

Are you physically unable to perform the duties of the job for which you are applying? Yes No 

You may provide any additional information you feel pertinent to your application and not covered below:

 
 

Applicant Authorization
Read Carefully Before Acknowledging Acceptance
I certify that the facts contained in this application for employment at Hillcrest are true and complete to the best of my knowledge. I understand that any misrepresentations, falsifications, or deliberate omissions will result in my disqualification as an applicant or immediate dismissal from any ensuing employment.  I authorize investigation of all statements herein.

I also authorize by my signature below or a copy thereof or electronic mark of acceptance, the organizations and individuals referred to herein to furnish information to Hillcrest.

Hillcrest shall be held harmless should it, in processing this employment application, rely on information provided from these sources, even if the information provided is inaccurate or erroneous. Additionally, I understand that nothing contained in this employment application or in the granting of an interview or in any policies, procedures or handbooks that I might receive, is intended to create an employment contract between Hillcrest and myself. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon Hillcrest. If an employment relationship is established, I understand that I have a right to terminate my employment at any time, for any reason or for no reason, and Hillcrest retains a similar right regarding discontinuation of my employment subject only to the terms of a collective bargaining agreement, if one applies, and to the full extent permitted by law.
 **Electronic acknowledgment of the above statements is required.
A check box is provided for this purpose at the submit button.
 
Referral Source: How did you find out about this job?


Specify appropriate additional source information (i.e.. What state office, school, organization, employee, newspaper, internet site, etc.

**Check this box to verify you have reviewed the Applicant Authorization