MHK Employment Application

Mile High Kids and Community Development, Inc. Application for Employment
Mile High Kids and Community Development, Inc. is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration of employment on a basis by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.
First*
M.I.
Last*
Date

MonthDayYear
Date
Street Address
City*
Phone*
Format: (000) 000-0000.
Email*
example@example.com
Date Available*

MonthDayYear
Date
Social Security No.*
Position Applied for*
Are you a citizen of the United States*

YesNo
If no, are you authorized to work in the U.S.?*

YesNo
Have you ever worked for the Head Start Program? Yes or No. If yes, when *
Have you ever been convicted of a criminal offense (felony or misdemeanor)? If yes, explain*
Education
High School*
Address*
From*
To*
Diploma*
College*
Address*
From*
To*
Degree*
Other
Address
From
To
Degree
Please list three professional references.
Full Name*
Relationship*
Company*
Phone*
Format: (000) 000-0000.
Address*
Full Name*
Relationship*
Company*
Phone*
Format: (000) 000-0000.
Address*
Full Name*
Relationship*
Company*
Phone*
Format: (000) 000-0000.
Address*
Company*
Phone*
Format: (000) 000-0000.
Address*
Supervisor*
Job Title*
Responsibilities*
From*
To*
Reason for Leaving*
May we contact your previous supervisor for a reference?*

YesNo
Company*
Phone*
Format: (000) 000-0000.
Address*
Supervisor*
Job Title*
Salary*
Responsibilities*
From*
To*
Reason for Leaving*
May we contact your previous supervisor for a reference?*

YesNo
Company*
Phone*
Format: (000) 000-0000.
Address*
Company*
Supervisor*
Phone*
Format: (000) 000-0000.
Address*
Supervisor*
Job Title*
Starting Salary*
Responsibilities*
From*
To*
Reason for Leaving*
Military Service
Military Branch
From
To
Rank at Discharge
Type of Discharge
If other than honorable, explain
The relationship between you and Mile High Kids and Community Development, Inc. is referred to as “employment at will.” This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or Mile High Kids and Community Development, Inc. No representative of Mile High Kids and CommunityDevelopment, Inc. has authority to any agreement contrary to the foregoing “employment at will” relationship. You understand, if hired, your employment is “at will,” and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except a written statement signed by the Board of Directors. I certify that my answers are true and complete to the best of my knowledge.If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.*
Date*

MonthDayYear
Date
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Mile High Kids and Community Development, Inc. Application for Employment

Education

Military Service

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