START Family Mentor Job Application
Directions :
1) Fill out all of Section One.
2) Fill out all that applies to you in Section Two.
3) Only submitted and complete job applications will be considered.
4) Qualified applicants will be directly contacted by the Fund for Social Change
Section One
Full Name (First and Last):
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E-mail:
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Primary Telephone Number:
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Address:
*
Can you start in June, 2009?
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Yes
No
Are you a US Citizen or do you have the legal right to accept employment in the United States?
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Yes
No
Please check the languages you are fluent in:
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English
Spanish
List any other languages you are fluent in (if applicable):
Please answer the following questions in the space provided below:
What are some of your life experiences that prepares you for this position?
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What about your character makes you a good candidate for this job?
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It is prefered that Family Mentors have prior involvement with ACS. In the space provided, please briefly describe your families’ history with ACS.
Include how you became involved and how the situation was resolved.
It is prefered that Family Mentors have overcome drug abuse.
In the space provided, please briefly describe your experiences with drugs, and how you now demonstrate your commitment to sobriety.
Section Two
Education
Family Mentors must have EITHER a High School Diploma OR a GED.
Do you have a High School Diploma?
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Yes
No
Name & Address of High School:
Do you have a GED?
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Yes
No
Date GED received:
Highest level of formal education you have attended: (if applicable)
List all colleges, universities or other schools you have attended: (if applicable)
Institution name(s) and Locations:
If you graduated, type of degree received:
Date degree received
Major/Minor or special course:
Please list any trainings you have completed related to child welfare and/or parent leadership:
Employment History
Begin with your present or most recent job, and list your work experience for up to three (3) jobs. If you have experience working with families involved with the child welfare system, please be sure to include that.
Job 1 (Current or most recent)
Employer name and address
Employer's phone number
Supervisor's name
Dates of employment (Include month and year):
From:
To:
Title of position held
Duties
Reason for leaving
Hours worked per week
Job 2
Employer name and address
Employer's phone number
Supervisor's name
Dates of Employment (Include month and year):
From:
To:
Title of position held
Duties
Reason for leaving
Hours worked per week
Job 3
Employer name and address
Employer's phone number
Supervisor's name
Dates of Employment (Include month and year):
From:
To:
Title of position held
Duties
Reason for leaving
Hours worked per/week
Activities
Please list any activities and/or volunteer experiences you have that further qualifies you for this job:
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