SVdP Employment Application

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.

Background Information

Applicant Full Name: *

E-mail: *

Address: *

City: *

State: *

Zip Code: *

Telephone: *

Position Applying for: *

Location: *

Type of employment desired: *

Part-Time

Full-Time

Temporary

Please list availability: *

Available Anytime

Available Days

Available Nights/Weekends

Have restrictions on certain days/times

Date you will be available to start work *

Available for overtime if necessary? *

Yes

No

What are your salary or pay expectations? *

Can you travel if required by this position? *

Yes

No

Only with company-provided vehicle

Have you ever been previously employed by our organization? *

Yes

No

Why did you leave? *

What date/location were you employed? *

Will Visa or Immigration Status prevent lawful employment? *

Yes

No

If you are under 18, can you furnish a work permit if it is required? *

Yes

No

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation? *

Yes

No

Please explain: *

Were you known by any other name at any job or school listed? *

Yes

No

What name? *

Drivers license number (Complete ONLY if driving is an essential job duty):

How did you hear about this position? *

Educational History:
List school name and location, years completed, course of study, and any degrees earned

High School:

College:

Technical School:

Other:

Skills and Qualifications:
Summarize any job-related training, skills, licenses, certificates, and/or other qualifications:

Employment History:
Please provide all employment information for your past three employers starting with the most recent.

Employer 1: *

Position held: *

Telephone #: *

Address:

Dates employed: *

Job summary: *

Reason for leaving: *

Employer 2:

Position held:

Telephone #:

Address:

Dates employed:

Job summary:

Reason for leaving:

Employer 3:

Position held:

Telephone #:

Address:

Dates employed:

Job summary:

Reason for leaving:

Why do you want to work for St. Vincent de Paul? *

If you are currently employed, why are you looking for another job?

Have you ever been discharged from a job? *

Yes

No

If yes, please explain. If no, write N/A. *

Professional References:
List the names of 3 references (do not include relatives, friends or the employers listed above):

Reference #1 *

Title: *

Phone/Email *

Years Known: *

Reference #2

Title:

Phone/Email

Years Known:

Reference #3

Title:

Phone/Email

Years Known:

Please submit a copy of your resume. *

Acknowledgement

I hereby authorize the Society of St. Vincent de Paul to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.

I understand the Society of St. Vincent de Paul cannot guarantee that my application will be considered for any or all positions available or that my application will be considered for any specific period of time.

If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.

I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.

I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.

I agree to the above acknowledgement *

Yes

No

Todays Date: *