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
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
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Company
Phone
Address
Supervisor
Job Title
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?

YesNo
Company
Phone
Address
Supervisor
Job Title
Salary
Responsibilities
From
To
Reason for Leaving
May we contact your previous supervisor for a reference?

YesNo
Company
Phone
Address
Company
Supervisor
Phone
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.

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

Education

Military Service

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