It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classifications. Please carefully read and answer all questions. You will not be considered for employment if you fail to completely answer all the questions on this application. All questions must be answered...
Position applying for | |
---|---|
Hours | Full Time Part Time |
Shifts | 1st 2nd 3rd 4th 5th |
Status | Regular Temporary |
Are you authorized to work in the U.S. on an unrestricted basis? | Yes No | Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment.) | Yes No | Have you been told the essential functions of the job or have you been viewed a copy of the job description listing the essential functions of the job? | Yes No | Can you perform these essential functions of the job with or without reasonable accommodation? | Yes No |
School Name | Degree | Address/City/State | |
---|---|---|---|
School | |||
Other |
Name | Address/City/State | Phone | Relationship |
---|---|---|---|
Job Title #1 | ||||
Company Name | Address/City/State | |||
Start Date | End Date | |||
Supervisor's Name | Phone Number | |||
Starting Salary | Ending Salary | |||
Reason for Leaving | May we contact your present employer? | Yes No | ||
Duties: |
Job Title #2 | ||||
Company Name | Address/City/State | |||
Start Date | End Date | |||
Supervisor's Name | Phone Number | |||
Starting Salary | Ending Salary | |||
Reason for Leaving | May we contact your present employer? | Yes No | ||
Duties: |
|
|||
Applicant Signature | Date | ||