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Who We Are
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Employment Application
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First Name
Last Name
Middle Initial
Social Security Number
Other names by which you have been known
Current Street Address
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E-mail Address
Additional Details
Salary Desired
md2s5mhy6ols
Type of Work Desired
Full Time
Part Time
When will you be available to start work?
Immediately
One Week
Two Weeks
One Month
Are you legally able to work in the United States?
Yes
No
Are you a Veteran?
Yes
No
Have you ever been fired from a job?
Yes
No
Work Experience
Most Recent Position
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Location
Dates Employed
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Ending Salary
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Responsibilities
Supervisor
Telephone
Previous Position
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Location
Dates Employed
Starting Salary
Ending Salary
Reason for Leaving
Responsibilities
Supervisor
Telephone
Previous Position
Company
Location
Dates Employed
Starting Salary
Ending Salary
Reason for Leaving
Responsibilities
Supervisor
Telephone
Education and Training
High School
Name and Location
Years Attended
Degree or Diploma
College
Name and Location
Years Attended
Degree
College
Name and Location
Years Attended
Degree
Trade, Vocational, Business School
Name and Location
Years Attended
Degree
Please describe any other education and training relevant to the position:
Computer Skills
Microsoft Word
Excel
PowerPoint
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Access
Quick Books
Microsoft Outlook
N-Focus
Other
Language Skills
Are you fluent in any language other than English?
Yes
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If yes, please list language(s):
Gallup Strength Finder
If you have completed the Gallup Strength Finder in the last two years, please list your top five signature themes:
Professional References
In addition to your supervisors listed previously, please supply three additional professional references (not related to you) who can supply first-hand information on your work skills and performance within the past four years.
Name
Daytime Phone
Relationship
Years Known
Name
Daytime Phone
Relationship
Years Known
Name
Daytime Phone
Relationship
Years Known
Please Read Before Signing
I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this application unfavorable. I understand that Falsification could result in termination of my employment. I authorize the Child Advocacy Center to make such investigation and inquiries of my personnel, employment and educational history as may be necessary in arriving at an employment decision. In addition to the references provided above, I understand my current supervisor will also be contacted. I further understand that if I am a top applicant for the position, a criminal history background check, including the Central Registry of Abuse and Neglect, will be conducted. Verification of academic credentials may also be requested.
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