Application for Employment
Please fill out this form to the best of your abilities.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Position you are applying for:
*
Shelter Attendant
Case Manager
Shelter Manager
How did you hear of this job opening?
*
Please Select
Online Search
Newspaper Listing
Personal Referral
Other
If you chose other, please explain.
Date available:
*
Desired pay:
*
Type of employment desired
*
Part-time
Full-time
Weekends
Days
Nights
Seasonal
Temporary
Please indicate the days you are available to work
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Education History
Please let us know a little information about the type of education you've received
Please let us know that last year of schooling you completed (example: 12th grade)
*
Did you complete high school?
*
Yes
No
Name of high school attended
*
List other certifications, licenses, or specialized training
Name of college you attended OR name of business, tech or trade school you attended (optional)
City/State
Field of study
Years attended
Graduated?
Yes
No
Degree/Certificate (example: Bachelor's Degree)
If you attended or completed other schooling, please list here. Please include the name of the school you attended, the state the school is in, how long you attended, whether or not you earned a degree, and the type of degree you completed.
Employment History
Please list your last 3 employers. Begin with your current or most recent position first. Failure to do so may result in an incomplete application.
Employer #1
Employer Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Job title
*
Start date
*
End date
Reason for leaving
Brief description of your duties
*
Supervisor name
*
Supervisor phone number
*
Please enter a valid phone number.
Employer #2
Employer Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Job Title
Start Date
End Date
Reason for Leaving
Brief description of you duties
Supervisor Name
Supervisor Phone Number
Please enter a valid phone number.
Employer #3
Employer Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Start Date
End Date
Reason for Leaving
Brief description of your duties
Supervisor Name
Supervisor Phone Number
Please enter a valid phone number.
If your name has changed or you have gone by another name during any periods of employment, please list name(s) here.
Can you, upon conditional offer of employment, provide genuine documentation establishing identity and eligibility to be employed in the United States?
*
Yes
No
About You
If you are a follower of Jesus, please share your Christian testimony below. If you need additional space, please send an email to info@jcfbn.org.
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I certify that all statements made in connection with this application (whether contained herein and/or in any supplements, or made by me or others at my request during the course of the employment process) are true and complete in all respects. I acknowledge and agree that any incorrect, incomplete, false, fraudulent, or misleading statements made by me, either verbally or in writing, and/or any omission, concealment, or failure to answer any question fully, completely, accurately, whether made by me or others at my request, will result in rejection of this application, denial of employment, or termination from employment if discovered after employment.
*
Yes
No
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