Application for Employment
Name
*
First Name
Last Name
Other names by which you are known?
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Availability/ When can you begin work?
-
Month
-
Day
Year
Date
Position you are applying for:
*
Location of Position:
Minimum Acceptable Salary?:
Are you willing to travel if the position requires?
*
Yes
No
Are you willing to work flexible hours to accommodate clients?
*
Yes
No
How did you learn about this position?
*
Internet Search
Indeed
LinkedIn
Referral
Social Media
Other Job Board
If you selected "Referral," please enter the name of your referrer, or if you selected "Other Job Board," please enter the site visited.
Are any accommodations needed in order for you to perform the job functions listed?
*
Yes
No
If you selected "Yes," please describe:
CAS Staff are required to have a physical with TB skin test prior to employment and bi-annually thereafter. Are you in agreement with this policy?
*
Yes
No
Education: (Please enter the information for your highest level of education)
*
Type of Diploma or Degree Received:
Did you graduate?
*
Yes
No
Currently Enrolled
Are you a veteran? If yes, be sure to include in work history.
*
Yes
No
List any professional, occupational licenses, or accreditations that you hold (If applicable, include license number and current status):
List any languages that you speak in addition to English:
Describe your computer skills:
Do you possess a valid Alabama Driver's License?
*
Yes
No
Do you have automobile insurance? (*Agency Requirement 100/300 minimum*)
Yes
No
Please attach your Work History/ Resume.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Reference #1
*
First Name
Last Name
Please specify your professional relationship with this reference.
*
Please Select
Former Manager/Supervisor
Former Co-worker
Former Subordinate/Direct Report
Client
Vendor
Professor/Academic Advisor
Other
If you selected "other," please clarify below.
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Reference #2
*
First Name
Last Name
Please specify your professional relationship with this reference.
*
Please Select
Former Manager/Supervisor
Former Co-worker
Former Subordinate/Direct Report
Client
Vendor
Professor/Academic Advisor
Other
If you selected "other," please clarify below.
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Reference #3
*
First Name
Last Name
Please specify your professional relationship with this reference.
*
Please Select
Former Manager/Supervisor
Former Co-worker
Former Subordinate/Direct Report
Client
Vendor
Professor/Academic Advisor
Other
If you selected "other," please clarify below.
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Agency Statement of Policy/Pre-Employment Statement
STATEMENT OF POLICY Children’s Aid Society of Alabama (CAS) is an Equal Opportunity Employer. Federal law prohibits discrimination in employment practices because of race, color, religion, sex, age, national origin, disability or veteran status. No question on this application is asked for the purpose of limiting or excluding any applicant’s consideration for employment because of his or her race, color, religion, sex, age, national origin, or due to disability or veteran status. PREEMPLOYMENT STATEMENT I understand and agree that: 1. The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other material, or during any interviews, can be justification of refusal of employment, or, if employed, termination from CAS employment. 2. Any offer of employment I may receive from CAS is contingent upon my successful completion of the agency’s total pre-employment screening process, including the agency’s receiving references that it considers satisfactory, and my satisfactory completion of any post-offer pre-employment medical examination that the agency may require. I also agree, if employed, to submit to a medical examination at any time at the agency’s request. I hereby consent to having the results of any post-offer pre-employment or post-employment medical exams I may be required to take disclosed to CAS. 3. As a condition of employment, I may be required to undergo and successfully pass any tests required of my position including but not limited to a screening for alcohol and/or drugs, criminal background, and motor vehicle records. I also understand and agree that, if employed, I may be required to submit to an alcohol or drug screening at any time at the discretion of CAS. I hereby consent to having the results of any such alcohol or drug screening I may be required to undergo disclosed to CAS. CAS reserves the right to terminate the employment relationship at any time if I fail to complete any of the steps or if any of the steps indicate positive results. CAS assumes no responsibility for placing me in another position if I were to be terminated. 4. In processing my application for employment, the agency may verify all the information provided by me, or may procure or have prepared a consumer or an investigative consumer report for this purpose concerning my prior employment, military record, education, character, general reputation, personal characteristics, criminal record, and credit history. I understand that upon written request to the agency, I will be informed whether an investigative consumer report was requested and given full information as to the nature and scope of this investigation. 5. I authorize and request that all of my present and former employers and those individuals I have listed as personal references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, hereby releasing them from any and all liability for damages arising from furnishing the requested information. 6. I should promptly report any job-related harassment, related complaints, or if I believe that I have been treated in an unlawful discriminatory manner to my supervisor or the Vice President of Human Resources of CAS by calling (205) 251-7148. I also understand that I should report any concerns about policies, procedures, practices, or any issue arising in the workplace to my immediate supervisor, where practicable, or the Vice President of Human Resources. 7. In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of CAS, including but not limited to CAS’ drug and alcohol policy, sexual harassment policy, and conflict resolution policy, and understand that my employment and compensation can be terminated with or without cause or notice, at any time, at the option of either the agency or myself. I further understand that no supervisor or representative of the agency, other than the Chief Executive Officer, has any authority to enter into any agreement with me for employment for any specified period of time or to make any agreement different from or contrary to the foregoing. I further understand that any such agreement, if made, shall not be enforceable unless it is in writing and signed by me and by the Chief Executive Officer of CAS.
Signature (By clicking submit, I am stating that I understand the CAS Pre-Employment Policy and that all information submitted is true and accurate.)
*
Submit
Submit
Should be Empty: