BGCG Employment Application

TRANSPORTATION
Do you have a Driver's License? *

Yes No
Proof of Insurance? *

Yes No
AVAILABILITY
Date Available *

Month Day Year
Employment Desired *

Full Time Part Time
Expected Hourly Rate (N/A if applying for Counselor in Training Position) *
Amount in $
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Holidays

WORK HISTORY
EMPLOYER I
Position
Job Description
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Month & Year
Salary
Phone Number

Area Code Phone Number
Reason for Leaving
_______________________________________________________________________________________

EMPLOYER II
Position
Job Description
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Month & Year
Salary
Phone Number

Area Code Phone 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 Name Last Name
Please select one

I consent I 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

Month Day Year
Date
Should be Empty:

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Child Abuse Record Information (CARI) Consent Form