Employment Step 1 of 5 20% Personal InformationName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Cell PhoneHome PhoneEmail* Applicants Gender*MaleFemaleAre you 18 or older?*YesNoAre you currently employed?*YesNoHave you worked for Adv Rock in the past?*YesNoAre you available for*Part timeFull timeFull or Part timeAre you legally authorized to work in the US?*YesNoHave you ever been convicted of a felony?*YesNoIf yes, please describe in detail.When are you available to start? Date Format: MM slash DD slash YYYY Hourly pay desired in US Dollars ($)What is your weekly availability?Position desiredDeskFitness InstructorRock Climbing InstructorPortable Wall Lead Staff (Seasonal)Portable Wall CoordinatorKid's Camp CounselorSeasonalYoga InstructorYouth Team Climbing CoachRoutesetterAny Education HistoryDid you graduate High School?*YesNoHigh School NameYears of High School completedPlease enter a number from 0 to 4.Did you graduate College?YesNoCollege NameYears of College completedPlease enter a number from 0 to 4.Courses studied in CollegeDid you graduate Graduate School?YesNoGraduate School NameYears of Graduate School completedPlease enter a number from 0 to 12.Courses studied in Graduate SchoolDid you graduate Business / Trade School?*YesNoBusiness / Trade School NameYears of Business / Trade School completedPlease enter a number from 0 to 8.Courses Studied in Business / Trade SchoolGeneral InformationMilitary Service?Yes, currently servingYes, in pastNoPlease describe any specials skills you have that may be applicable to the position you are applying for. Personal ReferencesReference #1 Name First Last Reference #1 Phone NumberRelationship to applicantReference #2 Name First Last Reference #2 PhoneRelationship to applicantReference #3 Name First Last Reference #3 PhoneRelationship to applicantEmployment HistoryCompany #1 NameSupervisor's Name First Last PhoneEmployed datese.g. May, 2009 - Feb, 2012Job TitleJob description / dutiesHourly payPlease enter a number from 0 to 50.Reason for leavingCompany #2 NameSupervisor's Name First Last PhoneEmployed datese.g. May, 2009 - Feb, 2012Job TitleJob description / dutiesHourly payReason for leaving Climbing Questionaire(Having no climbing ability does not preclude you from working at Adventure Rock.)How long have you been climbing?Are you a member of Adventure Rock?*YesNoDo you know how to tie a figure eight knot and a back up knot?*YesNoDo you know what double backing your harness is?*YesNoDo you know what the Yosemite decimal system is?*YesNoDo you know the Belay Commands?*YesNoDo you know how to Top Rope Belay?*YesNoAre you CWI certified?*YesNoDo you know how to Lead Climb?*YesNoDo you know how to Lead Belay?*YesNoDo you know what a Z Clip is?*YesNoDo you know what a Back Clip looks like?*YesNoHave you ever climbed outside?*YesNoIf so, where have you climbed?Other climbing skills Additional InfoAttach Resume' (optional)Is there anything else you'd like us to know about you? 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