NSI Employment Application

NSI Employment Application

Please complete this application to the best of your ability.
Personal Information
Full Name*

First NameMiddle NameLast Name
Current Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Date of Birth*

MonthDayYear
U.S. Citizen?*

YesNo
Email Address*
Phone Number*

Area CodePhone Number
Available Start Date*
Have you applied for a job/to volunteer with NSI before?*

YesNo
General Information
How did you hear about North Star Initiative?*
Please list any foreign languages that you speak:*
Spanish, Sign Language, etc.
What position(s) are you interested in applying for?*
What position(s) are you applying for?

Weekday Restoration CoachWeekend Restoration CoachOvernight Restoration CoachPart-time Bookkeeper
How many hours are you available to work per week?*

10-20 hours21-30 hours31-40 hoursOther

Please outline your availability with the corresponding day of the week:

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Start time
End time

Employment Information
I am currently:*

EmployedUnemployedRetiredA StudentOther
Current Employer*
If applicable, if not, type "n/a"
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Position/Title*

Prior Employment History (Please list most recent three places of employment. Or, instead, provide a CV/resume with this information at the end of this application.)

	Employer	City/State	Mo./Yr Started	Mo/Yr Ended	Position
Employer 1
Employer 2
Employer 3

Education

Please list all education. Or, instead, please attach a CV/resume that contains this information at the end of this application. For all information not applicable to you, please leave the space blank.

	School/City & State	Major	Degree	Graduation Date
High School
Tech/Trade School
College/Undergrad 1
College/Undergrad 2
Grad School 1
Grad School 2

	Institution/City & State	Program/Specialty	Program Director	Completion Date
Internship
Clinical
Other

Relevant Experience
Please describe current or previous community activities, memberships, etc.*
Brief description of hobbies, interests, skills, and areas of training/expertise:*
Have you previously volunteered with an organization working with survivors of sex trafficking, abuse, or exploitation?*

YesNo
If yes, where?*
Please type n/a if not applicable
Describe your previous and/or current volunteer/employment (sex trafficking related or otherwise) experience that may be applicable to this position:*
How would you describe your knowledge about human trafficking?*

I've heard of this overseas, but I do not know what is happening in the U.S.I know it happens in the U.S., but do not know what happens in Lancaster County.I am aware of current news in Lancaster County regarding human trafficking.This is all completely new to me.Other
Faith Background
Describe your spiritual journey as a follower of Christ:*
Please answer, "How can one have a relationship with God?"*
What church do you attend?*

Confidential Information
Have you ever been convicted of a crime (including a DUI)?*

YesNo
Have you ever been convicted of neglect, abuse or substance dependency?*

YesNo
Do you have a physical or emotional condition, including alcohol or drug dependence, which may effect or is likely to effect your ability to perform your professional duties?*

YesNo

Emergency Contact Information*

	Full Name	Phone Number	Relationship to You
Emergency Contact 1
Emergency Contact 2

References and Resume/CV

Please list two peers who have personal knowledge of your ethical character and ability to work cooperatively with others. Please do not list individuals related to you by family, professional partnership or financial institution.

	Name:	Employer	Title or Relation	Email	Phone Number	Years Known:
Reference 1
Reference 2
Reference 3

Please provide your Resume/CV:

Upload a File

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By clicking "Submit" and providing my signature below, I understand and affirm that all of the answers provided on my application are true. I understand that misrepresentations or omission of facts called for is cause for dismissal. I hereby authorize North Star Initiative to investigate my background and to contact the above given references for the purposes of determining my suitability as a potential employee.

Employment is contingent upon a satisfactory outcome of a criminal history check, employment verification, and a fingerprint check.
Signature*

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NSI Employment Application

Personal Information

General Information

Employment Information

Education

Relevant Experience

Faith Background

Confidential Information

References and Resume/CV