AVCP RHA Employment Application Form

AVCP RHA Employment Application

Fill out the form below for every postion you are applying for.
Name*

First NameLast Name
Birth Date*

MonthDayYear
Phone Number*
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Resume and Files

Cancelof
Do you have the legal right for employment in the U.S.?*

YesNo
Within the past 5 years, have you been charged, convicted or released from prison for any criminal offense?*

YesNo
If yes, please explain. A conviction will not necessarily disqualify you from employment. Upon a finding of a criminal conviction, suitability will be determined based on the nature and frequency of criminal act, time elapsed since conviction, nature of employment, qualifications and whether you, the applicant, have been rehabilitated.
Do you claim Alaska Native/Indian Preference?*

YesNo
If yes, please provide tribal affiliation and enrollment number.
Have you ever applied with AVCP RHA before?*

YesNo
If yes, what date?

MonthDayYear
Date
Have you ever been employed with AVCP RHA before?*

YesNo
If yes, Start Date.

MonthDayYear
Date
If yes, End Date.

MonthDayYear
Date
Have you ever applied with AVCP RHA before?*

YesNo
Position Applying For:*
Date Available for Employment:

MonthDayYear
Date
Type of Employment Status Desired*

Full TimePart TimeTemporarySeasonal
Have you read the job description?*

YesNo
If required for the position, do you have a current and valid driver's license?*

YesNo
If yes, Driver's License #:
Can you perform the essential position requirements, duties, and responsibilities of the position you are applying for without reasonable accommodation?*

YesNo
Are you willing to travel if required?*

YesNo
Are you willing to relocate if required?*

YesNo
Are you willing to work overtime if required?*

YesNo
Position Applying For:*
High School*
Did you graduate?

YesNo
College
Did you graduate?

YesNo
Degree Include Major and Minor if applicable
Trade / Technical School
Did you graduate?

YesNo
Degree, Diploma, or Certificate:
List any other professional, business, or civic membership/offices and/or special training received. Exclude any membership which would reveal sex, race, religion, national origin, age, ancestry, handicap or other protected status.
Hardware
Computer

NoviceIntermediateAdvanced
WPM
10-Key Calculator

NoviceIntermediateAdvanced
WPM
Multifunction Printer / Copier

NoviceIntermediateAdvanced
Other Hardware:
Software
Please list any skills using software and note experience as novice, intermediate, or advanced.
Foreign Languages
Please list any foreign language skills and note efficiency as read, speak and/or write.
Military Service
Have you ever served in the Armed Forces?

YesNo
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Branch
Rank at Time of Discharge
Name your MOS and provide a brief description of your duties.
Employment History
May We contact this employer for reference?

YesNo
Description of Duties
May We contact this employer for reference?

YesNo
Description of Duties
May We contact this employer for reference?

YesNo
Description of Duties
References

Prove three business/work references who are not related to you and have knowledge of your work experience. If not applicable, list three school or personal references who are not related to you.
Reference 1
Reference 2
Reference 3
Any Additional Information You Would Like us to Consider?
Should be Empty:

AVCP RHA Employment Application

Hardware

Software

Foreign Languages

Military Service

Employment History

References