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Submit to:

JCVC Application
P.O. Box 143
Seymour, IN 47274 www.Jacksoncountyin.com


APPLICATION FOR EMPLOYMENT

The Jackson County Visitors Center is an Equal Opportunity
Employer.

The Jackson County Visitors Center does not discriminate on the
basis of age, religion, sex, race, color, sexual orientation, gender
identity, national origin, disability, or veteran status. It is our
intention that all qualified applicants are given equal opportunity
and that selection decisions be based on job- related factors.

Each question should be fully and accurately answered. No action can
be taken on this application until all questions have been answered. Use
blank paper if you do not have enough room on this application.

Please print except for signature on this application. 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.

POSITION OBJECTIVE

Position applying for Full-time Part-time Temp

Location Date Available to Start


Salary range desired $



PERSONAL INFORMATION

Last Name First Name MI

Street Address

City State Zip Code

Social Security # Home Phone # Mobile Phone #

Drivers License # License State



EDUCATION AND TRAINING

Name of High School # of years completed Diploma

College/Undergraduate # of years completed Diploma

City/State Type of degree/Area of study

Graduate School # of years completed Diploma

City/State Type of degree/Area of study
Additional training, education or certificates that are related to the position for which you are applying




Professional, trade, business or civic activities and office held (May exclude labor organizations and memberships that disclose
protected status)






List additional skills that are related to the position for which you are applying





Computer skills (software packages, website, social media)






EMPLOYMENT HISTORY
List names of employers in consecutive order with present or last employer listed first. Account for all periods of time,
including military service and any periods of unemployment. If self-employed, so state and supply business references.

EMPLOYER

Address

City State Zip Code

Dates of employment From To

Earnings Start Finish

Name, title and phone number of manager

Your job title

Responsibilities






Reason for leaving

May we contact this employer at this time? If not now, specify when

EMPLOYER

Address

City State Zip Code

Dates of employment From To

Earnings Start Finish
Name, title and phone number of manager

Your job title

Responsibilities






Reason for leaving

May we contact this employer at this time? If not now, specify when

EMPLOYER

Address

City State Zip Code

Dates of employment From To

Earnings Start Finish

Name, title and phone number of manager

Your job title

Responsibilities






Reason for leaving

May we contact this employer at this time? If not now, specify when

REFERENCES

List name and telephone number of three people we can contact immediately.

Name Company

Relationship Years known Phone Number


References Current Email
Name Company

Relationship Years known Phone Number

References Current Email

Name Company

Relationship Years known Phone Number

References Current Email
Please provide a brief paragraph answering the following questions.


What is the greatest strength that you would bring to this position?




















A person in the community says that Jackson County does not have
anything to offer in regards to tourism, what would you say?
When you work, do you prefer to have a plan and stick to it or change it if
you feel that you need to make adjustments? Defend your choice.




















How would you describe your leadership skills?





















In what ways do you think that social media and marketing are important to the JCVC?
CRIMINAL HISTORY/MISCONDUCT

Conviction of a crime does not automatically disqualify you from employment since the nature of the offense,
date and the job for which you are applying will also be considered.

Are you presently being investigated or under a procedure to consider your discharge for misconduct by your
present employer or have you offered a resignation because of misconduct to your previous employer?

Have you ever been reprimanded, disciplined, discharged for misconduct or asked to resign for misconduct from
a prior position?

Have you ever resigned from a prior position without being asked, but under circumstances
involving your employers investigation of your mishandling of funds, or of your criminal
conduct?


Have you (a) ever been convicted of a crime, other than a minor traffic offense; or (b) ever entered a plea of
guilty or a plea of no contest (nolo contendere), or has any court ever deferred further proceedings without
entering a finding of guilty and placed you on probation, for any crime, other than a minor traffic offense?



If yes to any of the above, please explain, in detail, including the date of the charge, the entity having
jurisdiction, the court action, the charged offense in question, and the address of the court or entity involved.
Attach additional pages if necessary.







Yes ___ No ___
Yes ___ No ___
Yes ___ No ___
Yes ___ No ___



Affidavit, Consent and Release Please Read Carefully Before Signing This Application

I certify that the information contained in this employment application and any resume submitted to the
company is true and complete. I understand that any false information or omission will disqualify me from
further consideration for employment and will result in my dismissal if discovered at a later date.

I authorize the investigation of any and all statements contained in this application. I also authorize, whether
listed or not, any person, school, current employer, past employers and organizations 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 I will be required to successfully pass a criminal background check, a credit check, driving check
and a reference check and I authorize the completion of all checks.

I understand that this application, verbal statements by management or subsequent employment does not create
an express or implied contract or employment nor guarantee employment for any definite period of time. If
employed, I understand that I have been hired at the will of the employer and my employment may be terminated
at any time, with or without reason and with or without notice.



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



Signature Date

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