[1]
Are you available to work: _____ Full Time ______ Part Time ( Mornings) _________ (Afternoons) ________
Name and Address of Course of Study No of Years Diploma
School Completed Degree
High School _______________________________________________________________________________
Undergraduate
College _______________________________________________________________________________
Graduate
Professional _______________________________________________________________________________
Other (Specify) _______________________________________________________________________________
Describe any specialized Training, apprenticeship, skills and extra curricula activities.
Describe any job related training received in the United States military
List professional, trade, business or civic activities and offices held. You may exclude membership, which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status:
References:
Other Qualifications:
Start with your present or last job. Include any job-related military service assignments and volunteer activities.
|
Employer
|
|
Dates Employed
|
Work Performed
|
|
Address
|
|
From To
|
|
|
Telephone Number
Job Title
|
|
|
|
|
Reason for leaving
|
|
Supervisor
|
|
|
Employer
|
|
Dates Employed
|
Work Performed
|
|
Address
|
|
From To
|
|
|
Telephone Number
Job Title
|
|
|
|
|
Reason for Leaving
|
|
Supervisor
|
|
|
|
|
|
|
|
Employer
|
|
Dates Employed
|
Work Performed
|
|
Address
|
|
From To
|
|
|
Telephone Number
Job Title
|
|
|
|
|
Reason for Leaving
|
|
Supervisor
|
|
Computer Skills
Software ________ Excel (Spreadsheets) ________ Word Processing ________ Access
________ PowerPoint _____________________________________Other
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in job or occupation for which you have applied? A review of the activities involved in such a job or occupation has been given. ________ YES ________ NO
Applicant’s Statement
I certify that answers given herein are true and complete. I authorize investigation of all statement contained in this application for employment as may be necessary in arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this
“at will “employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by a authorized executive of this organization.
In the event of employment, I understand that false or misleading information given in my application or interview (s) may result in discharge. I understand, also that I am required to abide by all rules and regulations of the employer.
_____________________________________________ ___________________________
Signature of Applicant Date