GREEN HILLS WOMEN'S SHELTER EMPLOYMENT APPLICATION

Transcription

1 Shelter Location: (Cameron or Trenton) GreenHillsWomensShelter.org Today's Date: First & Last Name: How long at this address?: Maiden: Street City State Zip Social Security Number: Home Phone: Cell Phone: Other: Position applied for (Please be Specific) : If under 18, please list age and date of birth: Have you ever applied with this organization before?: If yes, When did you apply and for what position?: When are you available for work?: How did you here about this position?: Yes No EDUCATION Complete for the highest level attended School Name and Location Course of Study Years Completed Degree/Diploma High School Vocational/ Trade School Undergraduate Graduate/ Professional Other May we contact school officials?: Yes No GHWS 2016 Page 1 of 5

2 WORK EXPERIENCE Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary. 1.) Name of employer: 2.) Name of employer: GHWS 2016 Page 2 of 5

3 3.) Name of employer: 4.) Name of employer: GHWS 2016 Page 3 of 5

4 Have you ever been convicted of a crime? Yes No (Conviction will not necessarily disqualify an applicant) If yes, explain number of convictions(s), nature of offense(s) leading to conviction, how recently such offense(s) were committed, sentences(s) imposed, and type(s) of rehabilitation(s): Do you drive a vehicle? Yes No Means of transportation? Do you have auto insurance? Yes No If yes, What ins. comp.? 1.) Do you have a valid drivers license? Yes No If yes, type of license?: Operator Chauffeur Are you able to travel to other shelters? Yes No REFERENCES Commercial (CDL) If yes, what state? List below the names of three persons not related to you and are not previous employers, whom you have known for at least on year. Name Phone number(s) Address Occupation Best time to call 2.) 3.) Did you complete this application yourself? If not, who assisted you?: Yes No An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Please use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying: GHWS 2016 Page 4 of 5

5 APPLICANT'S STATEMENT & WAIVER (Please read carefully before signing.) In exchange for the consideration of my job application by the Green Hills Women s Shelter (GHWS), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contests of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other GHWS practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of GHWS, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Program Director of GHWS. Both the undersigned and GHWS may end the employment relationship at any time, without specified notice or reason. If employed, I understand that GHWS may unilaterally change or revise their benefits, policies and procedures and such changes may include that reduction of benefits I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give GHWS permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release GHWS from any liability as a result of such contract. I understand that should I be offered employment with GHWS, I will be required to provide information in compliance with the Immigration Reform Act prior to my employment. I understand the position applied for may require driving during the course of work, I understand that I will be required to possess a current and valid driver s license and understand that I will be required to provide a copy of my official proof of insurance. I also understand that any offer of employment is contingent on my ability to be covered by auto insurance, if required for my position. I further understand that my employment with GHWS shall be probationary for a period of ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relationship with GHWS is terminable at will for any reason by either party. Signature of applicant: Date: GHWS is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, genetic information (GINA), national origin, citizenship, age or disability. We assure you that your opportunity for employment with GHWS depends solely on your qualifications. Thank you for completing this application form and for your interest in the Green Hills Women s Shelter. GHWS 2016 Page 5 of 5