Employment Form

Employment Application

GENERAL INFORMATION

Full Name

PrefixFirst NameMiddle NameLast NameSuffix

List other names you have been known

Are you 21 Years or Older?

Are you authorize to work lawfully in the United States?

Have you ever been convicted of a felony or misdemeanour?

Do you have a Valid Driver's License?

Do you have a reliable transportation?

Are you willing to undergo a background check as part of the hiring process?

CONTACT INFORMATION

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mobile Phone Number

Country CodeArea CodePhone Number

Home Phone Number

Country CodeArea CodePhone Number

E-mail

AVAILABILITY

Date Available

MonthDayYear

Employment Desired

Expected Hourly Rate

Amount in $

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

EDUCATION

Rows	SCHOOL (Name & Address)	COURSE	NUMBER OF YEARS COMPLETED	DIPLOMA DEGREE
HIGHSCHOOL
COLLEGE / UNDERGRADUATE
GRADUATE / PROFESSIONAL
CERTIFICATE & LICENSES

INTERESTS & HOBBIES

Please indicate the activities you enjoy and / or able to teach to someone else

SPECIALIZED EXPERIENCE, VOLUNTEER WORK, TRAINING, SKILLS

Employment & Experience

RESUME-

Upload a File

Employment history

*If you were unable to provide a resume, please complete the work history section in the application to ensure we have a full understanding of your experience and qualifications.

EMPLOYER I

Position

Job Description

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Month & Year

Supervisor

Phone Number

Area CodePhone Number

Reason for Leaving

_______________________________________________________________________________________

EMPLOYER II

Position

Job Description

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Month & Year

Supervisor

Phone Number

Area CodePhone Number

Reason for Leaving

_______________________________________________________________________________________

EMPLOYER III

Position

Job Description

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Month & Year

Supervisor

Phone Number

Area CodePhone Number

Reason for Leaving

Are you comfortable facilitating group discussions and interactive activities?

Are you comfortable sharing your ideas?

Are you CPR/First Aid certified?

What relevant skills or qualifications make you a strong fit for this role?

What motivates you to work with IamHER and empower middle school girls?