APPLICATION FOR EMPLOYMENT

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
1. POSITION(S) APPLYING FOR
2. HOW DO WE CONTACT YOU?
Name

First NameMiddle InitialLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Mailing Address (If different from above)

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone
Please enter a valid phone number.
Business Phone
Please enter a valid phone number.
Mobile Phone
Please enter a valid phone number.
Email
example@example.com
3. TELL US ABOUT YOUR EDUCATION
High School (Name)
High School (Address)
Highest Grade Completed
Diploma

YesOther
College Graduate?

YesNo (give total number of credits received below)
Your Name if Different While Attending College
4. GIVE NAME AND ADDRESS OF SCHOOL, MAJOR COURSE OF STUDY, AND DEGREE RECEIVED:
Undergraduate College/University

School Name

Address

Major Course of StudyDegree Received

Year Degree Obtained
Pertinent Undergraduate Courses
Graduate School

School Name

Address

Major Course of StudyDegree Received

Year Degree Obtained
Pertinent Graduate Courses

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.
1. NAME OF PRESENT OR LAST EMPLOYER

Name

Address

Job TitleSupervisor's Name

Number Supervised
May we contact this employer

YesNo
Dates worked: from Date to Date .
Job Information

Hours Per Week

Salary

Job DutiesPhone

Reason for Leaving
2. YOUR NEXT MOST RECENT EMPLOYER

Name

Address

Job TitleSupervisor's Name

Number Supervised
May we contact this employer

YesNo
Dates worked: from Date to Date .
Job Information

Hours Per Week

Salary

Job DutiesPhone

Reason for Leaving
3. YOUR NEXT MOST RECENT EMPLOYER

Name

Address

Job TitleSupervisor's Name

Number Supervised
May we contact this employer

YesNo
Dates worked: from Date to Date .
Job Information

Hours Per Week

Salary

Job DutiesPhone

Reason for Leaving
Give the names of three people, not relatives, who are familiar with you and/or your work:
1. Person

NameAddressPhone
2. Person

NameAddressPhone
3. Person

NameAddressPhone
Please upload Proof of ID, your resume and any training certificates that should be considered.

Cancelof

PEE DEE COMMUNITY ACTION PARTNERSHIP