APPLICATION FOR EMPLOYMENT

 

                                                                                                 

Position Desired: _________________________________________________________Date _________________________

Text Box: WE ARE AN EQUAL OPPORTUNITY EMPLOYER   APPLICANT’S STATEMENT   I understand that the School reserves the right to require me to submit to a drug test at any time and also reserve the right to require me to submit to an alcohol test and/or medical examination to the extent permitted by law.  I further understand that the school may contact my previous employers and I authorize those employers to disclose to the school all records and other information pertinent to my employment with them.  I release my previous employer from any liability as a result of their disclosure of information about me to the School.  I also authorize the School to provide truthful information concerning my employment with it to my future prospective employers and I agree to hold it harmless for providing such information.   I further understand that if employed I will be on a 90-day introductory period, and the termination for unsatisfactory performance during that period will not result in any School responsibility for unemployment benefits. By signing below, I certify that all the information that I provide on this application and in any interview will be true, complete and accurate.  I understand that if I am employed and any such information is later found to be false or misleading in any respect, I will be dismissed.    Furthermore, I understand that the school may obtain a consumer report or reports on me.  I authorize this school to obtain such reports for use in connection with my application for employment and for other employment-related reasons.  If hired, this authorization shall remain on file and serve as ongoing authorization for procurement of employment-related consumer reports at any time during my employment.  I understand that the term “consumer report” includes, but is not limited to, credit checks, criminal background checks, department of motor vehicle reports, and investigative consumer reports.  I further understand that the term “investigative consumer report” means a report in which information on my character, general reputation, personal characteristics, or mode of living is obtain through personal interviews with my neighbors, friends, or associates, or with others with whom I am acquainted or who may have knowledge concerning any such items of information.   DO NOT SIGN UNTIL YOU HAVE READ AND UNDERSTAND THIS STATEMENT     ____________________________________________               __________________________________________                                                        Date                                                                                  Signature of Applicant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL DATA

 

Name: ____________________________________________________         Social Security: _________________________

 

Present                                                                                                           How long have

Address: __________________________________________________         you lived there?  _______ Years __ _    Months

 

Previous                                                                                                          How long have

Address: __________________________________________________        you lived there?                  Years _ _ __Months

 

Telephone No._____________________________________________          Are you 18 years of age or older?   [  ] Yes [  ] No

 

Have you ever worked for this school before?                   [  ] Yes         [  ] No

If yes, please give date and position? _____________________________________________________________________

 

Do you have any friends or relatives working here?          [  ] Yes         [  ] No

If yes, Name:  ______________________________________________         Relationship:  __________________________

 

Have you ever pled guilty or “no contest” to a crime, been convicted of a crime, had adjudication withheld, prosecution deferred or do you have any criminal charges pending?    [  ] Yes          [  ] No

 

If yes, please give date and details of each: ___________________________________________________________

____________________________________________________________________________________________________

 

Have you ever been a defendant in a civil suit on an intentional tort (assault, battery, false imprisonment, invasion of privacy, intentional infliction of emotional distress, intentional wrongful death)?   [  ] Yes          [  ] No

 

            If yes, provide details:  ____________________________________________________________________________

_____________________________________________________________________________________________________

 

NOTE: Answering “Yes” to these questions does not constitute an automatic bar to employment.  Only those crimes which

             are substantially related to the position you are seeking will be considered.

 

PREVIOUS EXPERIENCE

 

Please describe any experience you have which you feel would assist you in performing the job for which you are applying.

 

 

 

 

 

 

_____________________________________________________________________________________________________

 

EDUCATION

 

 

School Name

 

 

Years Completed:

(Circle)

 

Diploma or

Degree

 

Describe Course

of Study  or  Major

Describe Specialized Training, Experience, Skills and Extracurricular Activities

 

Elementary

 

 

 

4   5   6   7   8

 

 

 

 

High School

 

 

 

9   10   11   12  

 

 

 

 

College/University

 

 

 

1    2   3   4 

 

 

 

 

Graduate/Professional

 

 

 

1   2   3   4  

 

 

 

 

Other

 

 

 

 

 

 

 

RECORD OF PREVIOUS EMPLOYMENT

 

Please list the names of your present or previous employers in chronological order with present or last employer listed first.  Be sure to account for ALL periods of time including military service and any period of unemployment.  If self-employed, give firm name and supply business references.

 

Present  or Past Employer

 

_________________________________

Address

 

_________________________________

City, State, Zip Code

 

 

Telephone

 

 

Employed:

From (mo/yr)

 

 

 

 

To (mo/yr)

 

Pay

Start

$

 

 

 

Final

$

Your Title or Position

 

 

 

 

 

Name Title of Last Supervisor

 

Reason for Leaving

 

 

 

 

 

 

Present  or Past Employer

 

_________________________________

Address

 

_________________________________

City, State, Zip Code

 

 

Telephone

 

 

Employed:

From (mo/yr)

 

 

 

 

To (mo/yr)

 

Pay

Start

$

 

 

 

Final

$

Your Title or Position

 

 

 

 

 

Name Title of Last Supervisor

 

Reason for Leaving

 

 

 

 

 

 

Present  or Past Employer

 

_________________________________

Address

 

_________________________________

City, State, Zip Code

 

 

Telephone

 

 

Employed:

From (mo/yr)

 

 

 

 

To (mo/yr)

 

Pay

Start

$

 

 

 

Final

$

Your Title or Position

 

 

 

 

 

Name Title of Last Supervisor

 

Reason for Leaving

 

 

 

 

 

 

 

Present  or Past Employer

 

_________________________________

Address

 

_________________________________

City, State, Zip Code

 

 

Telephone

 

 

Employed:

From (mo/yr)

 

 

 

 

To (mo/yr)

 

Pay

Start

$

 

 

 

Final

$

Your Title or Position

 

 

 

 

 

Name Title of Last Supervisor

 

Reason for Leaving

 

 

 

 

 

 

 

List all other employers you have had in the last ten (10) years.  __________________________________________________

 

 

 

 

Have you ever been terminated or asked to resign from any job?  [  ] Yes  [  ]  No  If Yes, please explain circumstances: 

 

_____________________________________________________________________________________________________

 

 

Please explain fully, any gaps in your employment history:  ______________________________________________________

 

 

 

PERSONAL REFERENCES

 

Please list persons who know you well – not previous employers or relatives.

 

 

Name

 

 

Occupation

 

Address

(Street, City and State)

 

Telephone

Number

 

Number of Years

Known

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

           

 

 

 

 

THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS.  IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY.

 

I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE AND ACCURATE.

 

 

 

 

 

_____________________________________                               _________________________________________________

Date                                                                                           Signature of Applicant

 

 

THIS SCHOOL IS AN EQUAL OPPORTUNITY EMPLOYER AND DOES NOT DISCRIMINATE BECAUSE OF RACE, COLOR, RELIGION, SEX, AGE, CITIZENSHIP, MARITAL STATUS, DISABILITY, OR NATIONAL ORIGIN.

 

 

Please send the application to the Registrar - glenda@britomiamiprivate.com or fax to (305) 448-0181