Three Sisters Irrigation District 
Employment Application Form

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE	Please mail or hand deliver completed application to:
PO Box 2230
68000 Highway 20 West
Sisters, Oregon   97759	OFFICE USE ONLY:
Date Received:
Reviewed by:	
	
PLEASE COMPLETE BOTH PAGES	DATE 		
Name 		
	Last 			First 			Middle 				
Present address 		
			Number			Street		City	State	Zip	
How long 		 Telephone (      )		

Position applied for  	______________	
How many hours can you work weekly?                           	Are you available for weekend work?                     	
Employment desired	FULL-TIME ONLY	  PART-TIME ONLY	    FULL- OR PART-TIME	
When are you available to begin work? _______________________________________ 	
Explain if more than 2 weeks_________________________________________	
Education	
Year	Name of School	 Related Courses	Certificate/Degree	

				
DO YOU HAVE AN OREGON DRIVER’S LICENSE?	 Yes	 No	
Driver’s license number                                          Expiration date 		
State of issue (if not Oregon)  _______         Operator      Commercial (CDL)     	
Have you had any accidents during the past three years?                            	How many? 		
Have you had any moving violations during the past three years?                     	How Many? 		
Are you willing to pursue an Oregon Commercial Driver’s License (required for employment)?                                	
			
	Skills		
	
Heavy Equipment Operator Experience	Operated	Trained on	Unknown	
Dump Truck				
Excavator				
Backhoe				
Other:				

	

APPLICATION FOR EMPLOYMENT	
Please list two references other than relatives or previous employers.	
Name  	Name  	
Contact Information:	Contact Information:	
E-Mail:	E-Mail:	
Telephone  (      )			Telephone  (      )		
Employment History				
Name of employer  	Employment Date 	Job Title 		
Reason for leaving (be specific)	From             
To               			
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	
Employment History				
Name of employer  	Employment Date 	Job Title 		
Reason for leaving (be specific)	From             
To               			
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	
Employment History				
Name of employer  	Employment Date 	Job Title 		
Reason for leaving (be specific)	From             
To               			
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.	

	
May we contact your present employer?	 Yes	 No	
If no, explain_________________________________________________________________________________________	
	
Signature _______________________________________      Date__________________________