Employment Application

Employment Application
Thank you for your interest in working with our organization. We appreciate your time and responses to our employment application.

If you proceed through interviews, you will be asked to complete several clearances prior to employment.

The following clearances must be current within the past year:
- FBI Fingerprint
- PA Child Abuse Clearance
- PA Criminal Record Check
Additionally, we will conduct reference checks and an additional background search through the National Sex Offender Public Website prior to extending an offer of employment.

You can read our Screening & Onboarding Policy for more information.
Personal Information
Please note, only United States citizens or individuals who have a legal right to work in the U.S. are eligible for employment. Verification of citizenship or legal right to work in U.S. must be submitted after an offer of employment has been made.
All employees of BGCA must be 18 years of age or older.
Legal First Name:*
Legal Middle Name:
Legal Last Name:*
Preferred Name:*
Are you authorized to work in the US?*
Are you 18 years of age or older?*
Phone # :*
Please enter a valid phone number.
Email:*
example@example.com
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a current legal driver's license?*
Which position are you applying for?*
Voluntary Information
EEO

We are required to compile the following information for statistical purposes in order to comply with certain federal regulations relating to Equal Employment Opportunity and Affirmative Action requirements. The information you provide is strictly on a volunteer basis, and the content of the information will not affect your eligibility for employment. Likewise, if you choose not to provide this information it will not affect your eligibility for employment in any way.
Please indicate how you identify yourself:

Hispanic or LatinoAmerican Indian or Alaska Native (Not Hispanic or Latino)Asian (Not Hispanic or Latino)Black or African American (Not Hispanic or Latino)Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)Two or More Races (Not Hispanic or Latino)White (Not Hispanic or Latino)I do not want to answer
Gender:
Veteran Status:
Disability Status:
Employment History
Please share your last three employers, with the most recent listed first.
Most Recent Employer:
Position:
Are you currently employed by this employer?
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for Leaving:
Employer:
Position:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for Leaving:
Employer:
Position:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for Leaving:
Education and Training
What is your highest level of education?*
Do you have any special training or certifications?*
Please list:*
Do you have a valid First Aid Certification?*
Do you have a valid CPR Certification?*
Relevant Experience
Please describe any present and past experience working with children:*
Do you have any special skills or interests you'd like to share?*
Please describe:*
Have you ever worked for or volunteered at a Boys & Girls Club?*
Which Clubhouse (Clubhouse Name, City, State) did you work or volunteer for and when?*
Cover Letter:

Cancelof
Resume:*

Cancelof
Other Information
Are you a former member of the Boys & Girls Club?*
Which Clubhouse(s)?*

Sixth StreetTurner StreetTeen CenterCumberlandAnother Clubhouse
How did you hear about this position?*
Please specify:*
Please list your minimum salary requirement:*
When would you be available to start?*

MonthDayYear
Date
Which Clubhouse(s) are you interested in working for?*

Sixth StreetTurner StreetTeen CenterCumberlandAdmin Office
References
Please provide contact information for at least 3 professional references.
First Reference Name:*
Company, Relationship to You:*
Phone #:*
Please enter a valid phone number.
Email:*
example@example.com
Second Reference Name:*
Company, Relationship to You:*
Phone #:*
Please enter a valid phone number.
Email:*
example@example.com
Third Reference Name:*
Company, Relationship to You:*
Phone #:*
Please enter a valid phone number.
Email:*
example@example.com
Additional Reference Name:*
Company, Relationship to You:*
Phone #:*
Please enter a valid phone number.
Email:*
example@example.com
Clearances
BGCA requires all employees to complete the following background clearances prior to working with children. These clearances must be current within the past year:
- FBI Fingerprint
- PA Child Abuse Clearance
- PA Criminal Record Check
Have you completed all 3 clearances within the past year?*
Have you been convicted of a felony in the past 5 years?*
If your clearances are current, please indicate the date each clearance was conducted and upload the original PDF certificate into the corresponding space. If you do not have these clearances yet, you will be asked to provide them if you are invited to proceed through the hiring process.
Date of FBI Fingerprint Clearance:

MonthDayYear
Date
FBI Fingerprint Clearance Certificate:

Cancelof
Date of PA Child Abuse Clearance:

MonthDayYear
Date
PA Child Abuse Clearance Certificate:

Cancelof
Date of PA Criminal Record Check:

MonthDayYear
Date
PA Criminal Record Check Certificate:

Cancelof
Authorizations
Statement 1

I understand that I will not be permitted to work for the Boys & Girls Club of Allentown until I have completed all 3 required background clearances at my own expense and have submitted them to the organization for review. BGCA will further conduct a 4th check of my background information through the National Sex Offender Public Website.

Following PA state laws and BGCA policies, I will also complete all required safety and child abuse prevention training modules as assigned to me by BGCA staff and prior to working with children.
Statement 2

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize the investigation of all statements contained herein and the references and employers 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 the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any arrangement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
Electronic Signature:*
Today's Date:*

MonthDayYear
Date
Should be Empty:

Employment Application

Personal Information

Voluntary Information

Employment History

Education and Training

Relevant Experience

Other Information

References

Clearances

Authorizations