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Please answer each question fully and accurately. No action can be taken on this application until all questions have been answered.

Personal Data

Employment Data

Employment Record

Start with your most recent job.

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Job #2

Job #3

Educational Data

High School

College

Other School #1

Other School #2

Skills

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Voluntary Self-Identification of Disability

Form CC-305
OMB Control Number 1250-0005
Expires 1/31/2017
Page 1 of 2

Why are you being asked to complete this form?



How do I know if I have a disability?

Autism Bipolar disorder Blindness Cancer
Cerebral palsy Deafness Diabetes Epilepsy
HIV/AIDS Impairments requiring the use of a wheelchair Intellectual disability (previously called mental retardation) Major depression
Missing limbs or partially missing limbs Multiple sclerosis (MS) Muscular dystrophy Obsessive compulsive disorder
Post-traumatic stress disorder (PTSD) Schizophrenia

  • Form CC-305
    OMB Control Number 1250-0005
    Expires 1/31/2017
    Page 2 of 2

    Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.


[i] Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.


PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

Please Read Before Submitting

I certify that all information is true and complete. I understand that any misleading or incorrect statements render this application void, and if employed, would be cause for termination. I hereby authorize Arapahoe Basin Ski Area (the "Company" or it's designees, to make such investigations and inquiries of my driving record, employment history, educational background, or criminal conviction history as may be necessary in arriving at an employment decision. I hereby authorize past employers, schools, and references named herein to give information in responding to inquiries in connection with this application. I release said companies, schools or persons from all liability for issuing this information. If employed, I agree to conform to the rules and regulations of the company. I understand that my employment can be terminated, with or without notice at any time, at the option of either the Company or myself. I hereby authorize the Company to deduct from my final paycheck upon termination any debts I may owe to the company (including amounts due for lost or damaged items for which I may be accountable).