CSRA EOA, Inc. Application

Are you a current employee of CSRA EOA, Inc.?
Please select an option

Date

MonthDayYear
Date
CSRA ECONOMIC OPPORTUNITY AUTHORITY. INC.
1261 Greene Street
P.O. Box 10104
Augusta Georgia 30903-2704
An EQUAL OPPORTUNITY EMPLOYER

Application for Employment

Please print all answers. We expect questions to be filled out completely and to the best of your ability. All applicants will undergo testing for the presence of illegal drugs as a condition of employment. Please fill out an application for each position for which you are applying.
Position for which you are applying:*
How did you learn about the position:*
Personal Information
Last Name:*
First Name:*
Middle:
Address*

Street Address

(APT #) If Applicable

CityState / Province

Postal / Zip Code
Home Phone Number:*
Cell Phone Number:*
Email*
example@example.com
Emergency Contact Information:
Name:*
Phone Number:*
Please answer the following questions by checking the appropriate column. If the answer is yes, please explain in the comment box at the end of the questions.
Have you been convicted of a felony within the past five years?*

YesNo
Are you now or have you ever knowingly been a member of any foreign or domestic, organization, association, movement, group, or combination of persons which is Totalitarian, Fascist, Communists, or subversive, or which has adopted, or shown a policy of advocation or approval of the commission of acts of force or violence to deny other persons their rights under the Constitution of The United States, or which seeks to alter the form of government of the United States by unconstitutional means?*

YesNo
Do you comply with the Immigration Reform and Control Act that requires you to be legally eligible for employment within the United States?*

YesNo
Educational Information
Choose the highest level of education completed:*
Please fill out the education information below to the best of your abilities. If none apply to you, please fill in with N/A.

Type a question*

Rows	Name of School	City/State	Graduated(Yes)?	Graduated (No)?	Degree	Major
High School
College
University
Vocational

Specialized Skills Check the programs and equipment that you can operated:
*

ComputerMicrosoft WordFax/Copy MachinesMicrosoft ExcelMicrosoft Power Point
Keyboard WPM*
Other?
Do you understand or speak any foreign language(s)?*

YesNo
If yes, please list the languages:
Please list any certificates, training, or experience you have that is relevant to the positions for which you are applying.
Please list any certificates, training, or experience you have that is relevant to the positions for which you are applying.
Please list any certificates, training, or experience you have that is relevant to the positions for which you are applying.
Do you have a valid driver's license?*

YesNo
If yes, list the class
Employment History Begin with the most recent
Name of Employer:
Type of Business
Supervisor's Name & Title:
Address of Employer
Phone Number of Employer

Area CodePhone Number
Dates Employed (month/year):
From (month/year)-
To (month/year)
Starting Job Title:
Ending Job Title
Starting Salary:
Ending Salary:
If you supervised employees, please indicate the number and give dates (month/year):
Reason for leaving:
Description of duties:
Previous Employer #2 (if applicable)
Name of Employer
Type of Business:
Supervisor's Name & Title:
Address of Employer:
Phone Number of Employer

Area CodePhone Number
Dates Employed (month/year):
From (month/year)-
To: (month/year):
Starting Job Title:
Ending Job Title
Starting Salary:
Ending Salary:
If you supervised employees, please indicate the number and give dates (month/year)
Reason for leaving:
Description of duties:
Previous Employer #3 (if applicable)
Name of Employer:
Type of Business:
Supervisor's Name and Title:
Address of Employer:
Phone Number of Employer:

Area CodePhone Number
Dates (month/year):
From: (month/year)-
To (month/year):
Starting Job Title:
Ending Job Title:
Starting Salary:
Ending Salary:
If you supervised employees, please indicate the number and give dates (month/year)
Reason for leaving
Description of duties:
I hereby give permission to contact the employers listed above concerning my prior work experience.
Candidate Signature
If there is a particular employer(s), you do not wish us to contact, please indicate which one(s).
If any please list below:
Are you a former employee of EOA?*

YesNo
If yes, give dates and program:
Do you have any relatives at EOA?*

YesNo
If yes, give names, relationship and department:
Are you a current or former Head Start parent?*

YesNo
Are you willing to travel?*

YesNo
Are you willing to travel frequently?*

YesNo
Are you currently employed?*

YesNo
When could you report to work? *
Personal References

Rows	Name	Business	Realtionship	Address	Phone Number
1
2.
3.

Give a brief explanation of your employment and career objectives*
I certify that the information within is accurate, true, and complete to the best of my knowledge and beliefs.
Candidate Signature*
Date*

MonthDayYear
Date
If you have a resume, please upload it below:

Browse Files

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Hello,

Your answer has indicated that you are a current employee of CSRA EOA, Inc. You will need to fill out an in-house application. Please click the link below "In-House Application" to complete the correct application.

In House Application
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