BGC Covington County Employment Application Form

Employment Application

Fill the form below accurately indicating your potentials and suitability to job 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
How were you referred to us?*

Walk-InReferralNewspaper AdFacebookTwitterLinkedInOther (please specify)
POSITION APPLYING FOR*

Unit DirectorProgram Coordinator/ Dir.Site TutorProgram Coordinator Asst.Program InstructorAdmin. AssistantReading InterventionistReading Intervention HelperOther
Please list ages you are willing to work with:

ElementaryMiddle SchoolHigh SchoolI work well with all agesN/A (I'm applying for an admin position)
Work availability

Full-TimePart-TimeEither
Have you previously worked for BGC Covington County?

YesNo
If so, when?
Are you a US Citizen?

YesNo
If no, are you authorized to work in the US?

YesNo
Have you ever been convicted of a felony? (This does not necessarily affect your application)

YesNo
If yes, please explain
Resume and Files

Cancelof
Are we allowed to contact previous supervisors?

YesNoI prefer to provide more clarity on which previous employers you may contact.
Training and Certifications (i.e. CPR, First-Aid, Life-Guard training, Childcare, etc.))
Military Service
Please list any military service below.
References

Please list three (3) professional references that are familiar with your work life.
Reference
Reference
Reference
Disclaimer and Signature

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
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: