2024 Employment Application - Program Coordinator

Employment Application
Project Kinship is an equal opportunity employer dedicated to a policy of non-discrimination in employment on any protected basis, including race, religion, color, sex (including breast feeding and related medical conditions), gender identity and expression, sexual orientation, national origin, ancestry, citizenship status, uniform service member and veteran status, marital status, pregnancy, age, protected medical condition, disability, genetic information, or any other protected status in accordance with all applicable federal, state, and local laws.

Resume*

Cancelof
Letter of Recommendation

Cancelof

Professional References
List individuals who are not related to you and who have knowledge of your work performance and work experience, preferably former supervisors.

Professional Reference 1
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Relationship*
Employer Name
Employer Address

Professional Reference 2
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Relationship*
Employer Name
Employer Address

Work Experience
List all jobs for the past 10 years, including part-time and self-employment, and explain periods of unemployment. A resume may be used to supplement (but not replace) this information.

Please begin with your most recent employer.
May we contact your present employer?*

YesNoN/A

Work Experience 1
Employer
Employer Phone Number
Please enter a valid phone number.
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Employment
Your title
Description of duties and responsibilities
Name of supervisor
Title of supervisor
Reason for leaving

Work Experience 2
Employer
Employer Phone Number
Please enter a valid phone number.
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Employment
Your title
Description of duties and responsibilities
Name of supervisor
Title of supervisor
Reason for leaving

Work Experience 3
Employer
Employer Phone Number
Please enter a valid phone number.
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Employment
Your title
Description of duties and responsibilities
Name of supervisor
Title of supervisor
Reason for leaving

Education
High School*
College*
Graduate School*
Trade/Vocation*
If you have not graduated from any of the above schools, please explain.
Describe your hobbies, interests, and memberships in professional organizations which may directly relate to the job for which you have applied (you may exclude those whose name or character indicate sex, sexual orientation, gender identity and expression, ancestry, race, religion, color, national origin, age, marital status, medical condition, disability, or any other protected classification of its members).
Summarize any information you think necessary to describe your full qualifications for the job to which you have applied.
Military (Complete this section if you served in the U.S. Armed Forces) Describe any other skills you acquired which directly relate to the job to which you have applied.

Disclosure to Job Applicant Pursuant to the California Consumer Privacy Act (CCPA)
As part of your job application and Project Kinship's evaluation of your candidacy, Project Kinship collects, receives, maintains, and uses the following types of Personal Information about you for the business purposes identified for each category.

Certification and Agreement - Please Read Carefully
- If hired by Employer, Employer will notify me of additional categories of Personal Information which it collects, receives, and maintains for business purposes. By signing below, I acknowledge and confirm that I have received and read and understand the CCPA disclosure, and I hereby authorize and consent to the Employer's use of the personal information it collects, receives or maintains for the business purposes identified above.
- I hereby certify that I personally completed the Employment Application and that the information contained in the Employment Application and on any resume provided to Employer is true, correct, and complete.
- I agree to have the information verified by Employer. I authorize Employer to contact my former employers, references, and any and all other persons and organizations for information bearing upon my qualifications for employment. I further authorize the listed employers, schools, and references to give Employer (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have. In addition, I release Employer, my former employers and other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of, or in any way related to, such investigation or disclosure.
- I understand that any misrepresentation, falsification, or omission of information on this Employment Application may result in my failure to receive an offer, or, if I am hired, in my dismissal from employment. I understand that nothing in this Employment Application, and anything conveyed in an interview, if granted, creates, or should be construed as creating, an offer of employment. I also understand that all offers of employment are conditioned on satisfactory proof of my identity and legal authority to work in the United States.
- If hired, I will comply with all rules and regulations of Employer.
- I understand that Employer reserves the right to require me to submit to a test for the presence of drugs and/or alcohol in my system prior to employment and at any time during my employment, to the extent permitted by law. I understand that Employer is committed to providing a safe and hazard-free work environment. I understand I must comply with Employer’s Drug and Alcohol Policy. I also understand that any offer of employment may be contingent upon passing a job-related physical examination. I consent to the disclosure of the results of any physical examination and related tests to Employer. I also understand that I may be required to take other tests, such as personality and honesty tests, prior to employment and during my employment. I understand that, should I decline to sign the consent or decline to take any of the above tests, my application for employment may be rejected or my employment may be terminated.
- I understand that bonding may be a condition of hire. If it is, I will be so advised either before or after hiring, and a bond application will have to be completed.
- Employment At-Will Agreement: It is hereby agreed by and between me and Employer that my employment shall not be for any specific duration and may be terminated at any time, by me or Employer, with or without cause and/or with or without prior notice. My status as an at-will employee may not be changed except in writing signed by me and the President of Employer. This express at-will acknowledgement supersedes any and all prior representations or understandings, whether written or oral, express or implied, issued by Employer, and is the entire agreement between us, regarding the terms and conditions of my employment.
This is the entire agreement between me and Employer regarding the length of my employment, and the reasons for termination of my employment, and this agreement supersedes any and all prior agreements regarding these issues. Oral representations or agreements made before or after my employment do not alter this agreement.

If any term or provision, or portion, of this agreement is declared void or unenforceable, it shall be severed and the remainder of this agreement shall be enforceable. If you have any questions regarding this certification and agreement, please discuss with a representative of Employer before signing.
My signature below attests to the fact that I have read, understand and agree to be legally bound to all of the above terms.
Name*

First NameMiddle NameLast Name
Today's Date*

MonthDayYear
Date
Signature*

Powered by Jotform SignClear
Should be Empty:

Employment Application

Applicant Information

Professional References

Work Experience

Education