EYC Employment Application


Personal Information
Employment Desired


Education History
Areas Of Special Interests
(Volunteerism, hobbies, clubs, etc.)
Former Employment
(List below last four employers, starting with last one first)
References
Give the names of three persons not related to you, whom you have known at least one year.
Shift Preferences
Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.”

* Denotes Required Field
       
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