Employment

Application for Employment

Please answer the following questions as thoroughly as possible. This will allow us to properly evaluate your skills and qualifications for employment opportunities available. Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify the Administrative Coordinator.

Name:
email:
Address:
City/State/Zip:
Phone: Best time to be reached:
For what position are you applying?
Are you of legal age to work in the United States? yes no
Are you legally eligible to work in this country? yes no
Have you been employed by First Step Home before? yes no
If yes, please note position and approximate dates of employment:
Have you read the job description? yes no
Are you capable of performing all the tasks listed in the job description? yes no
What lead you to First Step Home?
What date are you available to begin employment?
What is your desired salary range?
Type of employment desired: Full time Part Time No preference
Have you ever plead "guilty" or "no contest" to, or been convicted of a felony? yes no
If yes please provide dates and details:

ANSWERING YES TO THIS QUESTION DOES NOT CONSTITUTE AN AUTOMATIC BAR FROM EMPLOYMENT. FACTORS SUCH AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION, REHABILITATION AND POSITION APPLIED FOR WILL BE TAKEN INTO ACCOUNT.

If you worked previously under another name, please indicate that name:

Educational Background

High School:
Address:
Course of study:
Diploma/GED? yes no
College/University:
Address:
Major:
Minor:
Degree/Diploma? no yes Please specify:
Graduate Study:
Address:
Major:
Minor:
Degree/Diploma? no yes Please specify:
Other Studies:
Address:
Course of study:
Degree/Diploma? no yes Please specify:
Please summarize any other job-related skills, training, credentials and licenses that would qualify you for employment with First Step Home:

Employment History

Employer:
Position held:
Dates employed: From: To:
Employer address:
Supervisor's name and title:
Supervisor's phone number:
Compensation:
May we contact this employer? yes no
Employer:
Position held:
Dates employed: From: To:
Employer address:
Supervisor's name and title:
Supervisor's phone number:
Compensation:
May we contact this employer? yes no
Employer:
Position held:
Dates employed: From: To:
Employer address:
Supervisor's name and title:
Supervisor's phone number:
Compensation:
May we contact this employer? yes no

References

Please list people who are not related to you. List at least two people who can attest to your professional/educational experience.

Name: Relationship:
Address: Telephone:
Known for how many years?
Name: Relationship:
Address: Telephone:
Known for how many years?
Name: Relationship:
Address: Telephone:
Known for how many years?

I understand that as part of the application process with First Step Home (FSH), I authorize FSH to contact references and employers noted above to obtain job-related information. i also understand that this information will remain as part of my employment record. I agree to hold the above references harmless for any information they provide.

We are proud to be a drug-free workplace. Screening tests for alcohol and illegal drug use is required before hiring and during employment at FSH.

If employed by FSH, I understand that my employment can be terminated at any time for any reason by myself or FSH. If an employment commitment is made for any duration of time, I understand that it must be made in writing and approved by the Executive Director of FSH.

I agree that the information contained in this application is correct and complete to the best of my knowledge. I understand that any false statements can be cause for termination of employment. I also understand that FSH requires all employees to sign a conflict of interest statement, follow all agency policies and procedures and requires all employees to verify eligibility to work in the United States as outlined in the Immigration Reform and Control Act of 1986.

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