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    Address, City, State, Zip
    How did you hear about this position?
    In what section(s) are you willing to work?
    If yes, please indicate name of individual(s) and relationship.
    Are you at least 18 years of age?
    Are you legally eligible to work in the U.S.?
    QCBID participates in E-verify
    Do you have a valid Washington State Driver License?
    Do you have a valid Commercial Driver License (CDL)?
    Do you have a Public Pesticide Operator License?
    Please indicate the job skills you possess related to this position, including the amount of experience in each area.
    Explain any gaps in employment history; the timeframe and what you were doing during this period.
    No file attached.
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    Attach any certifications and/or licenses you possess and feel are applicable to the position you are applying.
    No file attached.

    Notice for Applicant/Employee

    The undersigned applicant/employee is hereby notified that Quincy-Columbia Basin Irrigation District intends to obtain an investigative consumer report for employment purposes through AcraNet. THIS AUTHORIZATION MUST BE COMPLETED AND RETURNED TO QCBID FOR YOUR APPLICATION TO BE CONSIDERED. EMAIL: humanresources@qcbid.org / FAX: (509) 787-3719

    FCRA Summary of Rights (Federal)

    This summary of your rights under the Federal Fair Credit Reporting Act is required to be provided to each applicant when an investigative consumer report for employment purposes may be obtained. THIS IS FOR YOUR INFORMATIONAL PURPOSES.

    FCRA Summary of Rights (WA State)

    This summary of your rights under the Washington Fair Credit Reporting Act is required to be provided to each applicant when an investigative consumer report for employment purposes may be obtained. THIS IS FOR YOUR INFORMATIONAL PURPOSES.

    Authorization

    I hereby give Quincy-Columbia Basin Irrigation District and their recruitment agent the right to make a thorough investigation of my present and/or past employment, work history, criminal record and credit history (if applicable to the position). I release from all liability all persons, companies and corporations supplying such information. I indemnify and hold harmless Quincy-Columbia Basin Irrigation District and their recruitment agent against any liability which might result from making such investigation. I understand that any false answer or statements on this form or on other required documents may result in denial of employment or discharge from employment.

    Additionally, I understand that nothing contained in this employment application or in the granting of an interview is intended to create an employment contract between Quincy-Columbia Basin Irrigation District and myself for any term of employment or employment benefit or procedure. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon Quincy-Columbia Basin Irrigation District.

    I agree that should an offer of employment be extended to me, this offer will be contingent on completing a pre-employment drug test, a physical examination (if required for the position, i.e.: CDL holder), criminal background check, credit history check (if applicable to the position), employment driving record, and reference checks. I recognize that a final offer of employment is contingent upon satisfactory results of the above. I understand, also, that I am required to abide by all policies, rules and regulations of the District as permitted by law.

    This certifies that this application was completed by me and that all entries on it and information in it are true and complete to the best of my knowledge.

    Digital Signature