Tucsonjcc.org



APPLICATION FOR

EMPLOYMENT

Please read carefully and complete all blanks where they apply. Please type or print using a pen.

Date applied: Position Desired:

Availability: ( Full Time ( Part Time Hours Available:

Last Name: M.I. First Name:

Address: City: State: Zip:

Home Phone: Social Security: Email:

Are you over age 18? ( Yes ( No Are you legally eligible for employment in the USA? ( Yes ( No

Permanent Address (if different from above):

Address: City: State: Zip:

Are you employed now? ( Yes ( No Date you will be available:

Have you ever been employed by the JCC? ( Yes ( No Date: Dept:

EDUCATION

|  |Name & Address of School |Did you Graduate? |Degree |Major |

|High School or GED |  |  |  |  |

|College or University |  |  |  |  |

|Post Graduate Work |  |  |  |  |

|Jewish Education |  |  |  |  |

The Tucson Jewish Community Center is an equal opportunity employer. No discrimination is made against any individual in any phase of employment in accordance with local, state and federal law.

List your employment record starting with your present and most recent employer. For any periods of unemployment, give reasons for unemployment. For self-employment or military service, please list dates and locations. Previous employment will be verified with your employer and references requested unless you indicate otherwise.

PREVIOUS EMPLOYMENT HISTORY

|Dates |Name, Address, and Phone |Job Title |Name of Supervisor |Starting & Ending |Reasons for Leaving |

| |Number of Employer | | |Salary | |

|From: |  |  |  |  |  |

|To: | | | | | |

|From: |  |  |  |  |  |

|To: | | | | | |

|From: |  |  |  |  |  |

|To: | | | | | |

|From: |  |  |  |  |  |

|To: | | | | | |

|From: |  |  |  |  |  |

|To: | | | | | |

Computer Skills: ( Word Perfect ( Excel ( Access ( PowerPoint ( Email/Internet

( Other programs:

Clerical Skills: ( Typing (WPM) ( Bookkeeping ( Steno (WPM)

← Other skills:

Mechanical Skills:

Other machine/equipment you can operate:

SPECIAL SKILLS AND QUALIFICATONS

Summarize special job-related skills and qualifications acquired from employment or other experience.

Have you ever been convicted of a felony? If yes, explain fully and provide dates. A conviction will not necessarily bar employment, and each case will be considered on its own facts.

REFERENCES

Give name, address, and telephone numbers of three references (at least 2 from previous employers).

1.

2.

3.

Are you able to fulfill the attendance requirements of the position applied for? ( Yes ( No

The Center reserves the right to terminate the employment of any employee at any time, with or without cause, at the will of the Center, in its sole and unlimited discretion, unless the Center has provided the employee with a written contract specifically stating otherwise. No manager, supervisor or other representative of the Center, including the Executive director has any authority to make any other type of employment agreement with any employee and no other type of employment agreements will be recognized at any time.

PLEASE READ CAREFULLY AND SIGN

I affirm that the information contained in this application is true to the best of my knowledge and understand that any statement herein may be verified without causing liability to the Jewish Community Center or the person supplying the information. I give the Jewish Community Center my permission to verify any information in this application, including my work history, references, general character and condition of health, and I understand my employment will be contingent upon the Center obtaining satisfactory information from the above sources.

I understand that part of this employment application is a release statement which I have signed authorizing private, public, medical institutions, corporations, and or education systems to provide the information as requested.

Although management makes every effort to accommodate individual preferences, I recognize that needs may require the following conditions to apply to my position: shift work, rotating work schedules, evening and weekend work. I understand and accept these as conditions of my continuing employment.

I hereby request and authorize any person, company, corporation, organization, agency, institution, government, and private, to release any and all information, including policy, medical, legal, personally, educational or otherwise for records concerning myself to the Jewish Community Center or its authorized agent.

I consent and request that all such person or agencies accept a photocopy of this authorization as valid authorization to give such information or records.

I understand that misrepresentation of the facts or false statements in this application will be cause for the application to no longer be considered, or for my immediate discharge if I am already employed.

I agree to abide by and conform to the rules and regulations of the Center.

Signature: Date:

Witnessed by: Date:

[pic]

Authorization / Consent for Background Verification

I understand that the Tucson Jewish Community Center will utilize the services of a consumer reporting agency as part of the procedure for processing my application for employment.

I understand that the consumer reporting agency will conduct an investigation which may include obtaining information utilizing motor vehicle records and criminal justice records for criminal convictions, civil records for past judgments, decisions or settlements related to my integrity and character.

I understand that before I am denied employment based on information obtained in the report, I will be provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act.

I hereby consent to this investigation and authorize the Tucson Jewish Community Center now, or while I am employed by Tucson Jewish Community Center to procure a report on my background from a consumer reporting agency.

Applicant/Employee Name (please print legibly)

Applicant/Employee Signature

Social Security Number Date of Birth

Address

City ST Zip

Phone Number Date

-----------------------

For office use only:

Route to Denise Wolf. This form must be initialed and returned to you prior to hiring. Expect results within 2 business days.

Approval _______Date_________

Submitted by_________________

Department__________________

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download