Employment Application

Full Name

First NameLast Name

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail

Confirmation Email

Position(s) applying for

Hourly wage expectations

Referral source

Are you over the age of 18?

Are you eligible to work in the United States?

Are you currently employed?

Date available for work

MonthDayYear

Are you available to work?

Other

Have you applied here before?

If yes, give date:

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:

Please complete the appropriate sections

Rows	Name & Location of School	Number of Years Attended	Did You Graduate?	Degree or Certification
GED / High School
Trade School
College
Graduate

WORK HISTORY Please list your four most recent employers, list the most recent first

1. Employer

Employer's Name (Most current)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

2. Employer

Employer's Name (Second most recent)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

3. Employer

Employer's Name (Third most recent)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

4. Employer

Employer's Name (Fourth most recent)

Address & location of business

Your title

May we contact this employer?

Supervisor's name

First and Last Name

Phone number

Area CodePhone Number

Start date

MonthDayYear

End date

MonthDayYear

Wages START:

Salary or Hourly

Wages END:

Salary or Hourly

Work performed:

Reason for leaving

ADDITIONAL INFORMATION

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

If yes, branch of service

Discharge date and rank

List job-related accomplishments, projects, and awards. (Exclude information that would reveal race, color, national origin, religion, gender, age, marital, or veteran status; medical condition, disability; or any other legally protected status.)

List any additional information you would like us to consider:

REFERENCES List three 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

Area CodePhone Number

Years acquainted

Relationship

2. Full Name

First NameLast Name

Company

Best phone number to reach them

Area CodePhone Number

Years acquainted

Relationship

3. Full Name

First NameLast Name

Company

Best phone number to reach them

Area CodePhone Number

Years acquainted

Relationship

AUTHORIZATION I understand that Homes of Hope 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 authorize Homes of Hope 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 give my full consent for all contacted individuals, including former employers, to provide information concerning this application, and I waive my right to bring any cause of action against these individuals for any and all liability for damages arising from furnishing the requested information to Homes of Hope. I acknowledge that a facsimile, email and/or photocopy of this form is as valid as the original. Pre-employment testing may be required (drug testing, background checks). I understand that this application is current for 60 days. At the conclusion of this time, if I have not heard from Homes of Hope 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, which means that either the employer or employee may terminate an employment relationship at any time, with or without cause or notice, for any reason or no reason.

I further acknowledge and understand that as a Christian 501(c)(3) Non-Profit organization, Homes of Hope reserves the right to prioritize candidates who share and agree with Homes of Hope's Statement of Faith and Vision and Mission and who agree to conduct themselves in accordance with these beliefs.

The Statement of Faith, Vision and Mission can be found on Homes of Hope Website: https://www.homesofhopeidwa.org/about-us

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

MonthDayYear

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