Country Jam (Grand Junction, CO)

Application for Employment June 2017

TO BE COMPLETED BY ANYONE WHO WANTS TO WORK AT COUNTRY JAM 2017.
Please note: In order to be considered, you must have valid and unexpired forms of
identification which will be collected if hired.
Background Information:
Name: _____________________________________Email: _____________________________________
Address: ____________________________________________ City:__________ State: _____ Zip:
__________
Phone: _____________________________________
Are you older then 18? (circle one) YES / NO
If you are under 18, you must email your work permit to work@countryjam.com
Work Permit Number: _____________________________________
Highest level of education completed? _____________________________________________
Name of High School? __________________________________________________________
Name of College? _____________________ Degree obtained or years attended? ___________
How much can you lift? (circle one) 0 / 10 / 25 / 50 / 75 / 100 / 125+ / NA
Emergency Contact Name: ______________________________
Emergency Contact Relation: ______________________________
Emergency Contact Number: ________________________________
Desired Employment Area:
No area is guaranteed, but we will try to match you up with at least one of your three
choices. You must select 3 different areas as your 1st, 2nd and 3rd choices.
(Choose out of - Check-in, Box Office, Toll Booths, Campgrounds, Parking, Artist Relations, VIP, Runner,
Bartender, Kitchen)

1st Choice: ________________________________

2nd Choice: ________________________________
3rd Choice: ________________________________
Have you worked for Country Jam in the past? (circle one) YES / NO
Year? _________Supervisor? ____________
Availability:
We require you to work the whole weekend in the same position, but in case anything
comes up we would like to be aware of your schedule.

Select days you are available to work (Thursday thru Sunday should all be selected)
Sunday 6/11 ____
Monday 6/12 ____
Tuesday 6/13 ____
Wednesday 6/14 ____

Thursday 6/15 (SHOW DAY) ____

Friday 6/16 (SHOW DAY) ____
Saturday 6/17 (SHOW DAY) ____
Sunday 6/18 (SHOW DAY) ____

References:
Personal Reference (Name, Contact # or Email, Relationship, Years Acquainted)
1. __________________________________________________________________________
2. __________________________________________________________________________
Employment Reference (Company Name, Contact #, Position and Years Employed/Current
Employee)

1. __________________________________________________________________________
AUTHORIZATION: I certify that all of the information submitted by me on the application
is true and complete and I understand that if any false information commissions or
misrepresentations are discovered, my application may be rejected and if I am
employed, my employment may be terminated at any time. In consideration of my
employment, I agree to conform to the company's rules and regulations, and I agree that
my employment and compensation can be terminated, with or without cause, and with
or without notice, at any time, at either my or the company's options. I also understand
and agree that the terms and conditions of my employment may be changed, with or
without cause and with or without notice at any time by the company. I understand that
no company representation, other than the president, and then only when in writing and
signed by the president, has any authority to enter into any agreement for employment
for any specific period of time, or to make any agreement contrary to the foregoing
terms.
DATE:__________________________________________
SIGNATURE:_____________________________________
Once complete, please email or mail to: Susan Allen 974 E. Ottley, Fruita, CO 81521
Work@CountryJam.com