Application for Employment

Application for Employment
Ronald McDonald House Central PA
745 West Governor Road • Hershey, PA 17033-2304
Phone: 717.533.4001 Website: RonaldMcDonaldHouseCentralPA.org
Name

First NameMiddle InitialLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Position Desired:
How did you hear about this position?
Date available:

MonthDayYear
Salary Requirements:
Are you legally authorized to work in the United States?
Emergency Contact:
Phone:
Format: (000) 000-0000.
Relationship:
EDUCATION
Name of High School:
Diploma:
City:
State:
College/University/Other:
Name of School:
Degree Earned:
Major:
Minor:
Did you graduate?
Additional Education, Certifications, or Training Relevant to This Position:
EMPLOYMENT HISTORY (Begin with most recent/current)
Employer:
City/State:
Supervisor:
Supervisor Title:
Phone:
Format: (000) 000-0000.
Your Position:
Dates of Employment:
Full-Time/Part-Time/Seasonal:
Start Salary:
End Salary:
Reason for leaving:
Employer:
City/State:
Supervisor:
Supervisor Title:
Phone:
Format: (000) 000-0000.
Your Position:
Dates of Employment:
Full-Time/Part-Time/Seasonal:
Start Salary:
End Salary:
Reason for leaving:
Employer:
City/State:
Supervisor:
Supervisor Title:
Phone:
Format: (000) 000-0000.
Your Position:
Dates of Employment:
Full-Time/Part-Time/Seasonal:
Start Salary:
End Salary:
Reason for leaving:
(Over please)

Employer:
City/State:
Supervisor:
Supervisor Title:
Phone:
Format: (000) 000-0000.
Your Position:
Dates of Employment:
Full-Time/Part-Time/Seasonal:
Start Salary:
End Salary:
Reason for leaving:
Have you ever been employed by this chapter or any other Ronald McDonald House chapters?
Have you ever volunteered for this chapter or any other Ronald McDonald House chapters?
POSITION REQUIREMENTS
Have you ever been convicted of a crime that has not been expunged or sealed?
If YES, please describe the conviction(s) including the date(s), and any information you would like us to consider. Please note: A conviction will not automatically disqualify an applicant from employment. Each situation will be evaluated based on its relevance to the position and other applicable factors.
or indicate N/A
This position requires the ability to perform the essential functions and physical requirements outlined in the job description, with or without reasonable accommodation. Can you meet these requirements?
If you require reasonable accommodation to perform the essential functions of this position, please describe.
Please list any computer programs or tools you are comfortable using independently (for example: email/Outlook, Microsoft Word, Excel, OneDrive, or other workplace software):
I may need assistance with basic computer tasks (such as sending email or logging in). *Please note: This information helps determine training needs and may not be required for all positions.
PROFESSIONAL REFERENCES
Please list three (3) professional references who can speak to your work performance, skills & qualifications. References may include current or former supervisors, managers, coworkers, or professional colleagues.
Professional Reference #1
Name:
Title:
Phone:
Format: (000) 000-0000.
Company:
Relationship:
Years Known:
Professional Reference #2
Name:
Title:
Phone:
Format: (000) 000-0000.
Company:
Relationship:
Years Known:
Professional Reference #3
Name:
Title:
Phone:
Format: (000) 000-0000.
Company:
Relationship:
Years Known:
Insert Resume

Cancelof
Insert Cover Letter

Cancelof
By applying for employment at Ronald McDonald House Central PA, I authorize Ronald McDonald House Central PA to contact my references or otherwise validate the information I have shared. I authorize Ronald McDonald House Central PA to conduct a child abuse, criminal background, and FBI clearance check. I agree to maintain privacy of any donor, guest, and/or patient information. I certify that all statements on this application are true and complete to the best of my knowledge.
Applicant Signature:
Date:

MonthDayYear
Ronald McDonald House Central PA is an equal opportunity employer and does not discriminate against any employee or applicant based on race, color, gender, national origin, age, religion, disability, veteran's status, or sexual orientation.
REV 9.29.26
Should be Empty:

Application for Employment

EDUCATION

EMPLOYMENT HISTORY (Begin with most recent/current)

POSITION REQUIREMENTS

PROFESSIONAL REFERENCES