Application for Employment - Community Action Partnership of Greater St. Joseph

Step 1 of 6

16%

Applicant Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address City State ZIP Code

Position Applying For

Employment History

Employer Information

Employer Name	Job Title	Actions

There are no Employers.

Maximum number of employers reached.

Education & Training

High School Name/Location

Received

Diploma

None

Other

College Name/Location

Years Completed

Major

Degree Received

Trade/Vocational School Name/Location

Years Completed

Program

Certification/Degree

Applicant Questionnaire

Are you at least 18 years or older?

Yes

If no, can you provide a valid work permit?

Yes

Are you authorized to work in the United States?

Yes

Have you worked for Community Action Partnership of Greater St. Joseph before?

Yes

If so, please provide employment dates

Do you have a child in our Head Start Program?

Yes

Are you now, or within the past thirty days, have you been a voting member of Community Action Partnership of Greater St. Joseph or on the Board of Directors or Policy Council?

Yes

Do you have relatives currently employed by Community Action Partnership of Greater St. Joseph or on the Board of Directors or Policy Council?

Yes

If yes, please provide name

Have you ever been convicted of, plead guilty or not contest to a felony, misdemeanor, or ordinance violation other than a minor traffic offense?

Yes

[NOTE: Conviction records may not necessarily bar employment, and are used to provide information for job related purposes only to the extent permitted by applicable law]

Do you have reliable transportation?

Yes

Do you have a current driver's license?

Yes

Please list class and special endorsements

Does your vehicle have valid insurance?

Yes

References

Please include the name and phone number/email of one personal (1) and two (2) professional references.

References

Name	Actions

There are no References.

Maximum number of references reached.

Certification and Acknowledgement

I certify that the information provided herein is true and correct to the best of my knowledge. I understand that, if employed by Community Action Partnership of Greater St. Joseph, falsified statements on this Application for Employment form will be considered grounds for termination. I authorize Community Action Partnership of Greater St. Joseph to investigate my work experience and any other matters related to my suitability for employment. I further authorize my former employers to disclose information related to my previous employment.

Signature(Required)