| *Name: |
|
*Are you 21 years of age: |
|
| Position Applying For: |
|
Social Security #: |
|
| *Complete Address |
|
*Years At Local Address: |
|
| *Phone: |
|
*Current Driver's License Class: |
|
|
| *Willing To Take A Drug Test? |
|
*Ever Been Arrested? |
|
| If You Have Been Arrested, Explain: |
|
*Are you able to perform essential functions of the position for which you are applying without special accommodations? |
| If NO, Explain: |
|
EDUCATION HISTORY
|
| *Choose Highest Degree Completed:
Year Graduated: |
*Name & Location of High School? |
|
| Describe Any Technical Schoo: |
|
EMPLOYMENT HISTORY
(Last Five Years): *If you have had more than three jobs in five years you are to bring additional employment history on another sheet of paper and attach to application.*
|
|
Employer:
Address:
Phone:
|
|
Date Started:
Date Ended:
May We Contact:
Job Title:
|
|
Supervisor:
Final Salary:
Job Description:
|
|
Reason For Leaving:
|
| ---------------------------- |
|
Employer:
Address:
Phone:
|
|
Date Started:
Date Ended:
May We Contact:
Job Title:
|
|
Supervisor:
Final Salary:
Job Description:
|
|
Reason For Leaving:
|
| ---------------------------- |
|
Employer:
Address:
Phone:
|
|
Date Started:
Date Ended:
May We Contact:
Job Title:
|
|
Supervisor:
Final Salary:
Job Description:
|
|
Reason For Leaving:
|
|
Describe skills, training, or experience related to the position that you are applying for:
|
Provide any volunteer/internship experience:
|
If you have had gaps of unemployment, explain those gaps:
|
If applying for a part time position, please list hours of availability:
|
Please describe what you believe Reality House Programs to be and the way you see the position you are applying for to fit into the organization:
|
How do you anticipate your demeanor will be with people who have been convicted of criminal behavior?
|
If hired, what type of relationship do you anticipate having with current or past participants of Reality House Programs?
|
|
If you have working experience in the following, please check each skill: |
Microsoft Word
Microsoft Access
Microsoft Publisher
Microsoft PowerPoint
Microsoft Outlook
Ten Key
Excel
Typing/WPM
|
I authorize the Release of Information concerning ALL of my current and previous employment to Reality House Programs, Inc. I understand that the information will include my period of employment, official title(s), duties and responsibilities, work habits, attitude, and reason for termination. I understand that Reality House Programs, Inc. staff will contact my references, investigate my employment & education history, and verify that the information that I provided in this application is accurate. By making such authorization, I release my previous employer, Reality House Programs, Inc., and the listed references from all liability and damage resulting from said release.
|
|
Reference 1:
Current Job:
Phone:
|
|
Reference 2:
Current Job:
Phone:
|
|
Reference 3:
Current Job:
Phone:
|
|
