New Opportunity Freedom School SLI Application

Education & Training
SLIs-Highest Level of Education Completed (Must have at least one year of college completed)*

College -Freshman YearCollege - Sophmore YearCollege -Junior Year
Jr. SLIs Grade Level

Rising 11thRising 12th
Current High School/College/ University*
Intended Major
Graduation Date

Skills, Honors & Certifications
List any skills you have that are relevant for the position you are applying for:*
List any accomplishments, honors or awards you have received:
List any significant or relevant experience you have:
List any certifications:
Why do you want to be a Servant Leader Intern?*

Employment / Volunteer History
Starting with you present or most recent employer, list in consecutive order all employment for at least the past three employers. If currently employed, may we contact your employer?*

YesNo
Company #1
Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Title / Position
Responsibilities
Name of Supervisor and Contact Info
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Company #2
Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Title / Position
Responsibilities
Name of Supervisor and Contact Info
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
Company #3
Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Title / Position
Responsibilites
Name of Supervisor and Contact Info
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date

References

(Please include at least one personal and one professional reference)
Reference #1
Please list name, contact information, relationship and years known.
Reference #2
Please list name, contact information, relationship and years known.
Reference #3
Please list name, contact information, relationship and years known.

Employment Verification
Are you legally authorized to work in the US?*

YesNo
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?*

YesNo
Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying.)*

YesNo
If you selected "Yes" to the previous question, please explain.
I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. Please acknowledge that all information is complete and accurate. PLEASE TYPE YOUR NAME BELOW*
Date

MonthDayYear
Date
Resume Upload

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New Opportunity Freedom School Servant-Leader Intern (SLI) Application