JOB APPLICATION

JOB APPLICATION
Buffalo's Concerned For Youth, Inc
1317 Forestdale Dr, Salisbury, North Carolina 28144
7042519906

Buffalo's Concerned For Youth, Inc is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state. or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.

Please fill out all of the sections below:
Applicant Name
Address

Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Telephone Number
Email Address
example@example.com
Date of Application

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Employment Position

Employment Position Position(s) applying for: Direct care staff ( part time)
How did you hear about this position?
What days are you available for work?
What hours or shift are you available for work?
If needed, are you available to work overtime?
On what date can you start working if you are hired?

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Date
Personal Information
Are you a U.S. citizen or approved to work in the United States?

YesNo
What document can you provide as proof of citizenship or legal status?
Have you ever been convicted of a criminal offense (felony or misdemeanor)?

YesNo
If yes, please state the nature of the crime(s). when and where convicted and disposition of the case
(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered).
Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying:
(Note: Buffalo's Concerned For Youth, Inc complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)
Education and Training
High School: Name, Location, Year Graduated, Degree Earned
College/University: Name, Location, Year Graduated, Degree Earned
Vocational School/Specialized Training: Name, Location, Year Graduated, Degree Earned
Military
Are you a member of the Armed Services?
What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
What military skills do you possess that would be an asset for this position?
Previous Employment
Employer Name
Job Title
Supervisor Name
Employer Address

Employer Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Employer Telephone
Dates Employed
Reason for leaving
Employer Name
Job Title
Supervisor Name
Address

Employer Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Dates Employed
Reason for leaving
Employer Name
Job Title
Supervisor Name
Address

Employer Address

Street Address Line 2

City, State and Zip CodeState / Province

Postal / Zip Code
Dates Employed
Reason for leaving
AT-WILL EMPLOYMENT
The relationship between you and the Buffalo's Concerned For Youth, 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 the Buffalo's Concerned For Youth, Inc. No representative of Buffalo's Concerned For Youth, Inc has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that 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 for a written statement signed by you and either our Executive Vice-President/Chief Operations Officer or the Company's President.
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JOB APPLICATION

Employment Position

Personal Information

Job Skills/Qualifications

Education and Training

Military

Previous Employment

AT-WILL EMPLOYMENT