Are you legally authorized to work in the United States? Yes No LAW VIOLATIONS IMPORTANT TO NOTE: Law violations will not necessarily disqualify you from employment consideration. Violations will be evaluated based on factors including the nature and gravity of the offense or conduct, the time that has passed, and the nature of the position. Have you ever been arrested, charged, or convicted for any offense anywhere other than minor traffic violations? Yes No If yes, please explain each and every occurrence. _____________________________________________________________________________________ Are you or any of your relatives, friends, or acquaintances currently charged with a criminal offense or under investigation for a criminal offense? Yes No If yes, please explain. EMPLOYMENT HISTORY LIST ALL EMPLOYMENT (do not refer to resume) – Current Employer: Salary: Yrs: From: To: Present Reference: Address: Email: Responsibilities: If necessary, is it okay to contact current employer? Yes No Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Responsibilities: Reason for leaving this employment: Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Email: Responsibilities: Reason for leaving this employment: Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Email: Responsibilities: Reason for leaving this employment: EMPLOYMENT HISTORY LIST ALL EMPLOYMENT (do not to resume) – Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Email:
Are you legally authorized to work in the United States? Yes No LAW VIOLATIONS IMPORTANT TO NOTE: Law violations will not necessarily disqualify you from employment consideration. Violations will be evaluated based on factors including the nature and gravity of the offense or conduct, the time that has passed, and the nature of the position. Have you ever been arrested, charged, or convicted for any offense anywhere other than minor traffic violations? Yes No If yes, please explain each and every occurrence. _____________________________________________________________________________________ Are you or any of your relatives, friends, or acquaintances currently charged with a criminal offense or under investigation for a criminal offense? Yes No If yes, please explain. EMPLOYMENT HISTORY – LIST ALL EMPLOYMENT (do not refer to resume) Current Employer: Salary: Yrs: From: To: Present Reference: Address: Email: Responsibilities: If necessary, is it okay to contact current employer? Yes No Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Responsibilities: Reason for leaving this employment: Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Email: Responsibilities: Reason for leaving this employment: Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Email: Responsibilities: Reason for leaving this employment: EMPLOYMENT HISTORY – LIST ALL EMPLOYMENT (do not to resume) Employer: Salary: Title: Yrs: From: To: Reference: Address: Phone: Email:
CommunityOutreachAssistantApplication.docx