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Application for Employment, Educational, and Volunteer Opportunities

We are an Equal Opportunity Employer, dedicated to a policy of non-discrimination in employment on any basis including race, age, gender, orientation, religion, or national origin.

APPLICANT INFORMATION:

Today's Date:

Last Name:

First Name:

Middle Name:

Phone Number

Email:

Referred By:

Present Address

Street Address:

City:

State:

Zip Code:

Permanent Address

Street Address:

City:

State:

Zip Code:

EMPLOYMENT/EXPERIENCE DESIRED:

Position:

Date can start:

Salary Desired:

Are you employed now?

If so, may we contact your current employer?

Have you ever applied to this company before?

If yes, when?

EDUCATION:

List the highest level of education you have currently achieved:

and from Which institution?

CURRENT STUDENTS:

Which educational institution are you attending?

Address:

Phone Number:

May we contact your educational institution?

What is your major or focus of study?

What is your anticipated graduation date?

Please note areas of interest by checking all that apply:

Security/Law Enforcement Mental Health Social work Government Non-profits Administration Other

If other please list:

List any agencies or organizations you are interested in establishing a career with:

AVAILABILITY:

Choose all times you are available to work:

Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM Saturday AM Saturday PM Sunday AM Sunday PM

Upload semester schedule if applicable:

Scheduling Notes:

EMPLOYMENT EXPERIENCE:

List Below Last Three Employers, Starting with the Last One First

Employer 1:

Employer Name:

Phone:

Address:

Are you still employed there?

If not, reason for leaving:

Employer 2:

Employer Name:

Phone:

Address:

Reason for leaving:

Employer 3:

Employer Name:

Phone:

Address:

Reason for leaving:

REFERENCES:

Give the names of three persons not related to you, whom you have known at least one year.

Reference 1:

Name:

Phone:

Relationship/Occupation:

Years Aquatinted:

Reference 2:

Name:

Phone:

Relationship/Occupation:

Years Aquatinted:

Reference 3:

Name:

Phone:

Relationship/Occupation:

Years Aquatinted:

EMERGENCY CONTACT INFO:

Name:

Phone:

Relationship:

Address:

CRIMINAL HISTORY:

Have you ever been arrested?

If yes, please explain

Have you even been civilly or administratively adjudicated to have engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility or other institution?

Have you ever been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse?

Have you ever been civilly or administratively adjudicated to have engaged or attempted to engage in the above conduct?

I authorize investigation of all statements contained in this application; I understand that misrepresentations or omission of facts called for are grounds for termination. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice.

Check to authorize

Date:

Digital Signature:

The Cardinal Community House is a resource dedicated to assisting individuals experiencing homelessness. Our work is to address urgent critical needs, like housing, while addressing underlying concerns to bring about life-changing solutions.

CONTACT US

(405) 232-0231

(405) 232-0270

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