• APPLICATION FOR EMPLOYMENT

  • Format: (000) 000-0000.
  • Have you filed an application with us before?*
  • Have you ever been employed with us before?*
  • Are you currently employed?*
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  • Are you lawfully authorized to work in the United States?*
  • Are you a Nebraska Resident?*
  • Do you have a valid Nebraska driver's license?*
  • Available Start Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Are you available to work:*
  • Can you travel if a job requires it?*
  • PROFESSIONAL REFERENCE*
  • PROFESSIONAL REFERENCE*
  • PROFESSIONAL REFERENCE*
  • EDUCATION RECORD*
    Rows
  • EMPLOYMENT EXPERIENCE Start with your present or last job, identifying all prior employers for the past 5 years. Include any job-related assignments and/or volunteer activities.*
  • EMPLOYMENT EXPERIENCE
  • EMPLOYMENT EXPERIENCE
  • EMPLOYMENT EXPERIENCE
  • EMPLOYMENT EXPERIENCE
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  • Have you engaged in sexual abuse in a prison, jail, lock-up community confinement facility, juvenile facility, or other institution?*
  • Have you ever been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse?*
  • Have you been civilly or administratively adjudicated to have engaged in the activity described in the previous two questions?*
  • Have you ever resigned during a pending investigation of an allegation of sexual abuse or sexual harassment?*
  • If you accept employment, do you understand that you have a continuing duty to disclose any adverse contact with law enforcement or sexual misconduct throughout the duration of your employment?*

  • I certify that answers given herein are true and complete to the best of my knowledge.

    I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

    This application for employment shall be considered active for a period of not to exceed six months.

    I UNDERSTAND AND ACKNOWLEDGE THAT, IF HIRED, MY EMPLOYMENT RELATIONSHIP WITH EPWORTH FAMILY RESOURCES WOULD BE OF AN “AT WILL” NATURE, WHICH MEANS THAT THE EMPLOYEE MAY RESIGN AT ANY TIME AND EPWORTH FAMILY RESOURCES MAY DISCHARGE EMPLOYEE AT ANY TIME FOR ANY OR NO REASON.

    In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the employer.

    I understand that Epworth Family Resources will only consider applicants that pass the following background checks:

    ·         Adult and Child Abuse Registry

    ·         OneSource Criminal Background

    ·         DMV Check

    ·         Nebraska State Patrol Criminal Check

    ·         Sex Offender Registry Check

    ·         Pre-employment Drug Screen

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • EQUAL EMPLOYMENT OPPORTUNITY

    Epworth Family Resources does not discriminate in hiring or employment on the basis of race, color, religion, national origin, sex, ancestry, veteran status, marital status, sexual orientation, disability, or age. No questions on this application are intended to secure information to be used for such discrimination.

    All applicants accepted for employment are placed on a temporary basis subject to an introductory period, and if in our judgment, it is found at any time during or after this introductory period that the employee is not suitable for work at Epworth Family Resources, employment may be terminated without other reason.

  • APPLICANT'S STATEMENT OF RELEASE

    I hereby authorize each former employer to release information and answer any questions asked by Epworth Family Resources regarding my previous employment. I also hold such persons harmless for giving any information within their knowledge or records.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
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