BGCG Employment Application

Boys & Girls Club of Garfield Employment Application
GENERAL INFORMATION
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Date
RESUME

Upload a File

Cancelof
List other names you have been known as
Which of the two sites we service at are you interested in working at?

490 Midland Ave Location (Elementary Aged Children)175 Lanza Ave Location (Middle School Students Only)
If you are applying for specific position, please list the job title here:
Are you 18 Years or Older?*

YesNo
Are you authorized to work lawfully in the United States?*

YesNo
Last Four Digit SSN (###-##-_ _ _ _)
Have you ever been convicted of a felony or misdemeanour?*

YesNo
If yes, please describe conditions:
CONTACT INFORMATION
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Mobile Phone Number*

Area CodePhone Number
E-mail*

TRANSPORTATION
Do you have a Driver's License?*

YesNo
Proof of Insurance?*

YesNo
AVAILABILITY
Date Available*

MonthDayYear
Employment Desired*

Full TimePart TimeCounselor in Training (Volunteer) MUST BE 16+
Expected Hourly Rate*
Amount in $
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Holidays

WORK HISTORY
EMPLOYER I
Position
Job Description
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Month & Year
Salary
Phone Number

Area CodePhone Number
Reason for Leaving
_______________________________________________________________________________________

EMPLOYER II
Position
Job Description
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Month & Year
Salary
Phone Number

Area CodePhone Number
Reason for Leaving
_______________________________________________________________________________________

Employee Verification Consent Form

This form is to consent to a representative for the Boys & Girls Club of Garfield to contact any employer listed on this application or attached resume to confirm the length of employment, employment status, salary rate, job title, and any additional information regarding the candidate's performance.
I First & Last Name consent to a representative for the Boys & Girls Club of Garfield to contact any employer listed on this application or attached resume to confirm the length of employment, employment status, salary rate, job title, and any additional information regarding my performance.
Name

First NameLast Name
Please select one

I consentI do not consent
Signature

Clear

All persons completing this form must read the following and sign below:

I consent to have the Department of Children and Families conduct a Child Abuse Record Information check to determine whether an allegation of child abuse of neglect has been substantiated against me. I certify that I am not currently being investigated for an allegations of child abuse or neglect. I understand that if a record of substantiated child abuse or neglect is found, of it I refuse to sign this consent form, I will not be permitted to sponsor or work at this or any other licensed child care center in New Jersey. I certify that all information I have given on this form is accurate and complete to the best of my knowledge.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Child Abuse Record Information (CARI) Consent Form