• PEE DEE COMMUNITY ACTION PARTNERSHIP

  • APPLICATION FOR EMPLOYMENT

  • THE LANGUAGE USED IN THIS DOCUMENT DOES NOT CREATE AN EMPLOYMENT CONTRACT BETWEEN THE EMPLOYEE AND THE AGENCY. THIS DOCUMENT DOES NOT CREATE ANY CONTRACTURAL RIGHTS OR ENTITLEMENTS. THE AGENCY RESERVES THE RIGHT TO REVISE THE CONTENT OF THIS DOCUMENT, IN WHOLE OR IN PART. NO PROMISES OR ASSURANCES, WHETHER WRITTEN OR ORAL, WHICH ARE CONTRARY TO OR INCONSISTENT WITH THE TERMS OF THE PARAGRAPH CREATE ANY CONTRACT OR EMPLOYMENT

  • 2. HOW DO WE CONTACT YOU?

  • 3. TELL US ABOUT YOUR EDUCATION

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    4.  GIVE NAME AND ADDRESS OF SCHOOL, MAJOR COURSE OF STUDY, AND DEGREE RECEIVED:

  • 5. JOB-RELATED TRAINING AND COURSE WORK, ETC.

  • DRIVER'S LICENSE INFORMATION

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  • PLEASE CAREFULLY READ THE FOLLOWING STATEMENTS

  • Authority to Release Information: By my signature, I consent to the release of information to authorized officers, agents, and/or employees of the PDCAP which may include but not be limited to information concerning my past and present work; including my official personnel files, attendance records; evaluations; educational records including transcripts; military service; law enforcement records; and/or any personnel record deemed necessary. I further release the organization, educational entity, present and former employers, law enforcement organization from any and all claims of whatever nature that I may have as a result of any inquiry or response given to such inquiries made in connection with my application for employment.

  • NOTICE TO INDIVIDUALS WITH DISABILITIES, DISABLED VETERANS AND VIETNAM ERA VETERANS

    Federal government contractors are subject to Section 402 of the Vietnam Era Veterans Readjustment Act of 1974 which requires that they take affirmative action to employ and advance in employment qualified disabled veterans of the Vietnam Era; and section 503 of the Rehabilitation Act of 1973, as amended, which requires that same of qualified disabled individuals.

    If you are a disabled veteran or have a physical or mental disability, you are invited to volunteer this information. The purpose is to provide information regarding proper placement and appropriate accommodation to enable you to perform the job in a proper and safe manner. This information will not adversely affect any consideration you may receive for employment. If you wish to be identified,

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  • 6. TELL US ABOUT YOUR WORK EXPERIENCE:

    Describe your work experience in detail, beginning with your current or most recent job. Include military service (indicate rank) and job related volunteer work, if applicable. Provide an explanation for any gaps in employment. All information in this section must be complete. A resume may be attached, but not substituted for completing this section.

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  • Dates worked: from   Pick a Date     to   Pick a Date   .

  • Give the names of three people, not relatives, who are familiar with you and/or your work:

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  • 7. SPECIAL SKILLS, ETC.

  • Certification of Applicant: By my signature, I affirm, agree, and understand that all statements on this form are true and accurate. Any misrepresentation, falsification, or material omission of information or date on this application may result in exclusion from further consideration or, if hired, termination of employment. If I have requested herein that my present employer not be contacted, an offer of employment may be conditioned upon acceptable information and verification from such employer prior to beginning work.

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