Goodman Community Center

Employment Application

Contact Information

First Name*:

Middle Name:

Last Name*:

Home Phone:

Cell Phone*:

Email Address*:

Preferred Method of Communication (Email, Home Phone, Cell):

Street*:

City*:

State*:

Zip Code*:

Employment Background

Employment Information

Position Applied For*:

Do You Prefer:

1) Are you legally eligible for employment in this country?

No Yes

2) Have you ever applied for employment with the Goodman Community Center?

No Yes

If yes, month and year

3) Have you been previously employed by the Goodman Community Center?

No Yes

If yes, what dates

Education

High School

School:

Location:

Diploma:

No Yes

Undergrad School

School:

Location:

Diploma:

No Yes

Degree / Area of study:

Grad School

School:

Location:

Diploma:

No Yes

Degree / Area of study:

List volunteer work or memberships in organization you consider relevant to ability to perform position applying for

References

Please give names, telephone numbers and email address of three references who are not related to you.

Reference

Name:

Phone Number:

Email:

How do you know this person?:

Reference

Name:

Phone Number:

Email:

How do you know this person?:

Reference

Name:

Phone Number:

Email:

How do you know this person?:

Work Experience

May we contact your current employer?

No Yes

May we contact your previous employers?

No Yes

Most Recent Employer

Employer:

Address:

Type of Business:

Job Title:

Dates of Employment (From - To):

Supervisor Name:

Supervisor Email:

Supervisor Phone:

Duties:

Reason for Considering to Leave:

Prior Employer

Employer:

Address:

Type of Business:

Job Title:

Dates of Employment (From - To):

Supervisor Name:

Supervisor Email:

Supervisor Phone:

Duties:

Reason For Leaving:

Prior Employer

Employer:

Address:

Type of Business:

Job Title:

Dates of Employment (From - To):

Supervisor Name:

Supervisor Email:

Supervisor Phone:

Duties:

Reason For Leaving:

Attachments

Upload File

Cover Letter (Word, PDF, Text: doc,docx,pdf,txt - 2MB: 2458760 bytes)

Resume (Word, PDF, Text: doc,docx,pdf,tx - 2MB: 2458760 bytes)

Transcripts (if necessary) (Word, PDF, Text: doc,docx,pdf,tx - 2MB: 2458760 bytes)

Agreement

Applicant Certification Agreement

I certify that all information provided on this application is true and I understand that any falsification or willful omission may result in immediate termination or refusal of employment. I authorize the Goodman Community Center to contact my references, employers (as indicated on the application and others referred to in this application to obtain any relevant information regarding my potential employment.

I understand the Goodman Community Center may terminate my employment at any time, with or without prior notice

Security Code

Referral Source Please specify the name of the person, site or organization.:

Signature

Type Name in Signature Box:

PLEASE NOTE: Upon successful application submission, you will be directed to a new web page with a confirmation message (in a green box) stating that your application has been submitted. Our affirmative action questionnaire will follow on the page. You will also receive an email to the address you supplied, with your application details.

If you are experiencing difficulty with this form, please contact Lisa Jacob, Assistant Director/Human Resources Director at 608.204.8026 or lisa@goodmancenter.org

Date: 2019-05-26 17:26:52

Application Processing

Goodman Menu

Employment Application

Contact Information

Employment Background

Education

References

Work Experience

Attachments

Agreement