APPLICATION FOR EMPLOYMENT

 

INSTRUCTIONS

PLEASE ANSWER ALL QUESTIONS. Resumes are not accepted in lieu of completion of this application. Note: This document was designed to use with several types of positions. Some questions may not be completely applicable to the job/position you are seeking; however, we ask that you fully complete all areas of information.

1. APPLICANT INFORMATION
,
Last four digits of SSN:
Referral Source

(NOTE: If yes, you may be required to furnish proof of exemption or partial waiver asdetailed by your State Child Labor Law.)

PLEASE NOTE: THE FACT THAT YOU ARE AWAITING TRIAL OR HAVE A CONVICTION RECORD WILL NOT NECESSARILY EXCLUDE YOU FROM CONSIDERATION.

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2. SKILLS AND QUALIFICATIONS
Computer Skills

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3. EDUCATION DATA

Please put your last diploma or degree completed:

 Name & Full Address for Each SchoolYears CompletedDegreeMajor Course of Study
High School
College
Graduate School
Trade, Bus., Night/Correspondence

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4. ORGANIZATIONAL/PROFESSIONAL INFORMATION.

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LIST YOUR LAST FOUR PREVIOUS EMPLOYERS (most recent first). Account for all time periods including unemployment, self-employment and military service. This section must be completed in full in addition to any attached resume.
Employer 1

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APPLICANT’S STATEMENT, AUTHORIZATION, AND RELEASE

I certify that the information provided in this Application for Employment is correct and complete. I authorize the investigation of this information and give permission for Children’s Foundation of Mid-America, Inc. (CFMA) to contact schools, previous employers, personal references and others to verify the data I have supplied. I release and indemnify CFMA from any claims or liability resulting from such inquiry. In addition, I release the schools, medical facilities, doctors, my previous employers, and other individuals from all liability as a result of responding to such inquiries. I understand that my misrepresentation, omission of fact(s), or incomplete information may disqualify me for employment with CFMA. In addition, if I am employed by CFMA, any discovery of misrepresentation or omission of fact(s) on this Application for Employment following my employment may result in discipline up to and including termination.

I understand that this application remains current for 90 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

I understand that employment with CFMA is at-will and for no guaranteed period of time and may be terminated by myself or CFMA with or without notice. I acknowledge that any promises, policies, business practices, procedures, or documents (including CFMA’s Employee Handbook and this employment application) do not constitute an employment contract or modification of the at-will employment relationship between CFMA and myself. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing expressed language are valid unless they are in writing and signed by the employer’s President/CEO.

CHILDREN’S FOUNDATION OF MID-AMERICA, INC. STATEMENT

CFMA does not discriminate on any basis prohibited by law. No questions will be unlawfully used for the purpose of limiting or excusing any applicant from employment. CFMA complies with the Americans with Disabilities Act of 1990. CFMA is an equal employment opportunity employer. It is the policy of the Company to make employment decisions without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, marital status or any other protected category.

I agree that I will provide proof of identity and legal work authorization, if I become employed with CFMA. I represent, certify, and warrant that I have read the application in its entirety and understand the foregoing, and voluntarily seek employment under these conditions.

AN EQUAL OPPORTUNITY EMPLOYER