Great Alaska Fish Camp and Safaris is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, natinal origin, sex, age or disability. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.

PERSONAL DATA
Each question should be fully and accurately answered. No action can be taken until this application (full and complete) is received by our office. Use blank paper if you do not have enough room on this application. PLEASE PRINT, except for your signature on this form. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job related information.

Job(s) Applied for_________________________

Today’s Date________________________

When are you available for employment?___________________ through________________________

LAST NAME____________________FIRST NAME____________________M/I___ TELEPHONE_________________

PRESENT STREET ADDRESS_____________________________CITY____________________ST_____ZIP_________

Are you 18 years of age or older? …………………………………….YES______ NO______

SOCIAL SECURITY NUMBER______________________________

Have you ever been convicted of any law violation (except a minor traffic violation)? YES____ NO____ (Yes answer does not necessarily disqualify you from a job offer, as date and nature of offense, along with job you are applying for will be taken into account). IF YES, GIVE DETAILS BELOW:

*For jobs that require driving ONLY- Do you have a valid drivers license? __________STATE ISSUED____________

CLASS OF LICENSE_____________ Have you ever had your license revoked or restricted? _____IF YES GIVE DETAILS:

EDUCATION

Name, Address and Location of School:_____________________________________________________________

High School or Equivalent_______________________________________________________________________

Highest grade completed______________-Did you Graduate?_____________

College or University ___________________________________________________________________________

College Major_____________________________________ College Degree___________________________

Highest Grade Completed__________________________ Did you Graduate? _______________________

Additional Educational and or vocational or technical info:

Name, address and location of school______________________________________________________________

Courses taken___________________________________________________________________________________

Courses Completed______________________________________ Degree/Diploma obtained?_______________

SKILLS

What skills or additional training do you have, what machines or equipment can you operate that are related to the job which you are applying for?

REFERENCES:

Give three references who are not related to you.

Name, address, and phone:

1.____________________________________________________________________________________________________

2.____________________________________________________________________________________________________

3.____________________________________________________________________________________________________

WORK HISTORY:

Please list names of employers in consecutive order with present or last employer listed first. Include periods of unemployment, as well.

NAME OF EMPLOYER (Present or last) ________________________________________________________________

Address______________________________________________city/state/zip___________________________________

Immediate supervisor_______________________________ TELEPHONE(_______)_____________________________

JOB TITLE AND DUTIES______________________________________________________________________________

_____________________________________________________________________________________________________

DATES OF EMPLOYMENT: FROM__________________TO: _____________________

PAY START___________ PAY ENDING_________________REASON FOR LEAVING__________________________

_____________________________________________________________________________________________________

NAME OF EMPLOYER (Present or last) ________________________________________________________________

Address______________________________________________city/state/zip___________________________________

Immediate supervisor_______________________________ TELEPHONE(_______)_____________________________

JOB TITLE AND DUTIES______________________________________________________________________________

_____________________________________________________________________________________________________

DATES OF EMPLOYMENT: FROM__________________TO: _____________________

PAY START___________ PAY ENDING_________________REASON FOR LEAVING__________________________

_____________________________________________________________________________________________________

NAME OF EMPLOYER (Present or last) ________________________________________________________________

Address______________________________________________city/state/zip___________________________________

Immediate supervisor_______________________________ TELEPHONE(_______)_____________________________

JOB TITLE AND DUTIES______________________________________________________________________________

_____________________________________________________________________________________________________

DATES OF EMPLOYMENT: FROM__________________TO: _____________________

PAY START___________ PAY ENDING_________________REASON FOR LEAVING__________________________

_____________________________________________________________________________________________________

NAME OF EMPLOYER (Present or last) ________________________________________________________________

Address______________________________________________city/state/zip___________________________________

Immediate supervisor_______________________________ TELEPHONE(_______)_____________________________

JOB TITLE AND DUTIES______________________________________________________________________________

_____________________________________________________________________________________________________

DATES OF EMPLOYMENT: FROM__________________TO: _____________________

PAY START___________ PAY ENDING_________________REASON FOR LEAVING__________________________

_____________________________________________________________________________________________________

Is any additional information relative to change of name, use of an assumed name, or any nickname necessary to enable us to check your work record? YES ___ NO ___ If YES, give names____________________________________

Are you presently employed? YES ___ NO ___ If YES, may we contact your present employer?

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I understand and agree that:

Any material misrepresentation or omission of fact in my application may be justification for refusal of, or if employed, termination from employment.

If is my understanding that the company will make a thorough investigation of my entire work and personal history and may verify all data given in may application for employment, related papers or oral interviews. I authorize such investigation and the giving and receiving of any information requested by the company and I release from liability an person giving or receiving any such information. I understand that falsification of data so given or any derogatory information discovered as a result of this investigation may prevent my being hired, or if hired, may subject me to immediate dismissal.

If requested by the management at any time, I agree to submit to search of any premises that has been assigned to me and I hereby waive all claims for damages on account of such examination.

If I am extended an offer of employment it may be conditioned upon successfully passing a pre-employment physical examination. I consent to the release of any and all medical information as may be deemed necessary to judge my capability to do the work for which I am applying, or in the future during my employment with the company.

Although management attempts to accommodate individual preferences, business needs may at times may make the following conditions mandatory: long hours, job tasks other that that which I was original assigned and flexible time off. If hired, I understand and accept these as conditions of employment.

I understand that this is an application for employment and that no employment contract is being offered.

I further understand that if I am employed, such employment is for an Indefinite period of time and that the company can change wages, benefits and conditions at any time. If employed, I understand that I have been hired at tour without cause and with or without notice, without liability for wages or salary except such as may have been earned at the date of such termination.

I have read, understand and by my signature consent to these statements.

SIGNATURE_________________________________ DATE: _______________________