APPLICATION PACKAGE

VISIONS OF TOMORROW APPLICATION FOR EMPLOYMENT

Position Applied for

Date of Application

Date

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Date of Birth

Date

Social Security Number

Drivers License Number

State

If you are under 18 years of age, can you provide required proof of your eligibility to work?

Are you currently employed?

May we contact your present employer?

Are you prevented from lawfully becoming employed in this country because you do not have a Visa or Immigration Status? (Proof of Citizenship or immigration status will be required upon employment

Have you been convicted of a felony within the last 5 years? (A criminal record does not constitute an automatic bar to employment and will be considered only as it relates to the job in question).

EMPLOYMENT EXPERIENCE

Start with your present or last job. Inlclude and job-related training you have had.

Employer Nameblanks Telephone Area Code Phone Number Street Address City State Zip Date of HireDate End DateDate Job Title Supervisor Reason for leaving Describe the type of work you did:

Employer Nameblanks Phone NumberArea Code Phone Number Address Street Address City State Zip Date of Hire Date End Date Date Job Title Supervisor Reason for leaving Responsibilities

Employer Name blanks Phone Number Phone Number Street Address City State Zip Date of Hire Date End Date Date Job Title Supervisor Reason for leaving blank Responsibilities

References

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

References

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

References

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at this time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an “at will” nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without any written document or by conduct unless such change is specifically acknowledges in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also that I am required to abide by all rules and regulations of the employer.

Date

Elementary School blanks Years Completed blank Jr High School Years Completed High School Years Completed Diploma College Years Completed Degree

BACKGROUND CHECK ACKNOWLEDGEMENT I, understand I will be hired by Visions of Tomorrow on a temporary basis until I receive a satisfactory background check. If the background check is not satisfactory, I understand I will be relieved of my position.