ROGER WILLIAMS PARK ZOO AND RHODE ISLAND ZOOLOGICAL SOCIETYEMPLOYMENTAPPLICATIONPEOPLE MAKE THE DIFFERENCE AT THE ZOO

1000 Elmwood Avenue, Providence, RI 02907
employment@rwpzoo.org

Roger Williams Park Zoo/ Rhode Island Zoological Society

EMPLOYMENT APPLICATION
Roger Williams Park Zoo/RI Zoological Society is subject to the Rhode Island Workers’
Compensation Act, R.I.G.L. § 28-29-1, et. seq to §28-38-1, et. seq.”

Please Note: Conditions of employment are stated at the end of this form. Please read carefully before you sign this application. If
you require reasonable accommodations to the application and/or interview process, notify a representative of RIZS Human
Resource Department.

(Application must be completed in full even if attaching a resume.)

Applicant Information
Applicants will receive consideration without discrimination based upon any legally protected class, including but not limited to race, age,color, religion, sex, marital status, national origin, physical or mental disability, protected impairment, military status, veteran status,
pregnancy, sexual orientation, gender identity or ancestry, or other legally protected status except where a bona fide occupational
qualification exists.

Full Name:
Present Address:(Phone:LastFirst

Street Address

Apartment/Unit #)

Date:

M.I.
CityState

ZIP CodeE-mail Address:

Date Available:
Position applying for:_____________________________
How were you referred to us?:Zoo Website

Social Media

Job/Volunteer Fair

Community Organization

Job Board

SchoolEmployee Referral

Other __________________Are you authorized to work in the U.S?

YESNO

Immigration status: As a condition of being considered for employment, all applicants must complete an Immigration and Naturalization
Service Form, I-9 and provide the required proof of citizenship or authority to work in the U.S.

YESNO

Have you ever applied to this organization
before?

YESNOHave you ever worked for the City ofProvidence?

YES

NO

Are any of your relatives presently employedwith the Organization?

YES

NO

Have you ever worked for this organization?

If yes, when?
If yes, when?
If yes, when?
If yes, name ofrelative?

If you are under the age of 18, can you supply a Certificate of Age or Special Limited Permit to Work form?
YESNO

PLEASE CHECK SCHEDULE AVAILABILITY:[ ] I am available and desire to work FULL-TIME and do not have restrictions on my hours and days.
[ ] I am available and desire to work FULL-TIME but have restrictions on the hours and days I can work.
[ ] I am available and only desire to work PART-TIME.
[ ] I am available and only desire to work SEASONALLY.
ATTENDANCE AND PUNCTUALITY INFORMATION:
A requirement of each job is punctuality and attendance unless otherwise agreed upon in writing Is there anything which wouldinterfere with your regular attendance and punctuality if you are offered a job with the organization?
[ ] YES [ ] NO If Yes, please explain: ___________________________________________________________

From

Previous Employment

To

Employer NameTelephone(Job Title

Address

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities)

Reason for leaving
FromToEmployer

Telephone(

Job Title

Address

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities)

Reason for Leaving
FromToEmployer

Telephone(Job Title

Address

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities)

Reason for leaving(By providing the above information, you are authorizing RWPZ/RIZS to contact your former employers regarding your suitability for employment.)

May we contact your present employer?

____ Yes____ No

Explain any gaps in work history: ________________________________________________________________________________Have you ever been discharged or asked to resign from a job? __Yes __No

If yes, explain: ________________________________

Education
EDUCATION

Name and locationof school

No. of yrs.
Attended

Degree Received Subjects studied/Major

High School
College or University
Graduate School
Trade, Business orCorrespondence School

RIZS SMOKE FREE WORKPLACE
By Rhode Island law, smoking is prohibited in all enclosed facilities within places of employment without exception. This
includes common work areas, auditoriums, classrooms, conference and meeting rooms, private offices, elevators, hallways,
medical facilities, cafeterias, employee lounges, stairs, restrooms, vehicles, and all other enclosed facilities.”

Professional References

Please list three professional references. Please do not list relatives. By providing these references, you are authorizing
Rhode Island Zoological Society to contact these individuals regarding your suitability for employment.
Full Name:
Company Nameand Address:

Relationship:

Full Name:
Company Nameand Address:

Relationship:

Full Name:
Company Nameand Address:

Relationship:

Years Known:
Phone:()
Years Known:

Phone:()
Years Known:

Phone:()Job Qualifications
As part of the job application process, someone from Roger Williams Park Zoo/ Rhode Island Zoological Society will describe to you
the essential duties and tasks of the applied-for jobs and the conditions in which you would be working. You will also be given
examples of the physical labor that must be performed. In addition, the education, work experience, training and skills necessary toperform these jobs will be explained. You then must answer the following questions:
Can you perform the duties of the job with or without reasonable accommodations? YES ________ NO _________
If the answer is No, please explain:__________________________________________________________________________________________________________________________________________________________________________________________________________
Roger Williams Park Zoo/ Rhode Island Zoological Society is committed to providing those reasonable modifications of job duties
and tasks, changes in working conditions or other accommodations which will assist otherwise qualified disabled applicants tosafely and satisfactorily perform the essential functions of the applied-for job.
No disabled applicant will be denied for employment unless: (1) The applicant is physically unable to satisfactorily perform theessential duties and tasks of the applied-for job; or (2) The applicant’s physical condition creates a significant risk of substantial
harm to the Applicant’s health and safety or that of other employees or to RWPZ/RIZS’s property if the Applicant does perform thisjob; and (3) There is no reasonable modification or change (accommodation) available which would enable the applicant tosatisfactorily and safely perform the job's essential functions.

Disclaimer and Signature
I hereby certify that the information stated above is to the best of my knowledge true, correct and complete. I understand thatany misrepresentation of facts or any false or incomplete statements in this application are sufficient cause for dismissal if I amemployed. I authorize the investigation of all statements contained in this employment application in return for being considered
for employment. I know that my completion of this application form does not mean that any positions are available. Iacknowledge that RIZS has not made any promise of employment to me. I understand that RIZS has no obligation to offer meemployment and that I have no right or entitlement to employment. I understand that any offer of employment by RIZS is for nodefinite period of time and that either RIZS or the employee may terminate employment at any time without prior notice andwithout any reason or cause. If I am employed I understand that RIZS can change my salary, and can terminate or change mybenefits or other compensation and any other terms and conditions of my employment at any time without prior notice to me,
without my agreement, and without any reason or cause. Questions regarding this disclaimer should be directed to any
employment interviewer before signing. The application will be given every consideration, but its receipt does not imply that theapplicant will be employed. I agree that any dispute concerning this pre-employment process or possible subsequent
employment; will be governed by Rhode Island law in a forum located within the State of Rhode Island.

Signature: ______________________________________________ Date: ________________