Basic Employment Application Form

Employment Application

Our client is an equal opportunity employer. Applicants will be considered regardless of race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status. Equal access to the hiring process, services, and employment is available to all individuals. Applicants requiring accommodations to the application and/or interview process should contact the Human Resource Representative.

Each question should be answered completely and accurately.

No action will be taken on this application until all questions have been answered and the application has been signed and dated. Verification of eligibility to work in the U.S. will be required if an employment offer is made.

Full Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Birth Date

Date

Social Security Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-mail

Confirmation Emailexample@example.com

Position(s) applying for

Wage expectations

Salary or Hourly?

Referral source

Are you over the age of 18?

Are you eligible to work in the United States?

Are you fluent in a foreign language?

If yes, what language(s)?

Are you currently employed?

Date available for work

Date

Are you available to work?

Have you been convicted of a felony/misdemeanor (other than traffic violations)?

If so, provide the location, date and result/outcome for each conviction:

EDUCATION

Highest level of education completed:

ADDITIONAL INFORMATION

Do you have a U.S. military service record?

If yes, branch of service

Discharge date and rank

List any additional information you would like us to consider:

REFERENCES

List two professional references, (business or work, not relatives) that you have known for at least one year. List at least one previous supervisor.

1. Full Name

First NameLast Name

Company

Best phone number to reach them

Format: (000) 000-0000.

Years acquainted

Relationship

2. Full Name

First NameLast Name

Company

Best phone number to reach them

Format: (000) 000-0000.

Years acquainted

Relationship

AUTHORIZATION

I understand that Kreative Kinnectionz Youth Outreach is making no employment offer at this time. I certify that the information in this application is correct to the best of my knowledge. I understand that any misrepresentation or omission of any fact in my application, resume, or any other materials, or during interviews is grounds for disqualification from further consideration for employment or for termination, if employed.

I authorize Kreative Kinnectionz Youth Outreach to contact any company, institution, or individual it deems appropriate to investigate my employment history, character, qualifications, credit history, driving record, and other relevant information, if job-related.

I understand that this application is current for 60 days. At the conclusion of this time, if I have not heard from Kreative Kinnectionz Youth Outreach and still wish to be considered for employment, it will be necessary to complete a new application.

I understand that if hired, employment is at-will, regardless of the employer, and may be terminated by myself, the employer or Kreative Kinnectionz Youth Outreach at any time, with or without cause or notice, for any reason or no reason.

By entering your name, you agree to accept the terms of the above document with an electronic signature.

You must agree to accept the terms of the document in order to submit an application.

Type signature

Date

Upload your resume, click Choose File

Upload a cover letter, click Choose File