Employment Application — GRAND FORKS SENIOR CENTER

Employment Application for the GF Senior Center

Grand Forks Senior Citizens Association Inc (DBA Grand Forks Senior Center)
620 4th Ave S Grand Forks, ND 58201
701-772-7245 www.gfseniorcenter.org
Equal Opportunity Employer

NOTE: If applying for a professional position at the Senior Center that would require a cover letter and résumé, please do not fill out this online application until you are ready to email the cover letter and résumé to director.gfscc@midconetwork.com within an hour of submitting the online employment application. THERE IS NO WAY TO SAVE THIS FILE. ALL OF YOUR INFORMATION MUST BE COMPLETED AT ONE TIME AND THEN SENT.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Preferred Phone

(###)

###

####

EMPLOYMENT DESIRED

Position Desired

Date You Can Start

Salary Desired

Are You Currently Employed

EDUCATION HISTORY

Name of High School

Location of High School

Years Attended High School

Did You Graduate from High School?

Name of College

Location of College

Years Attended College

Did You Graduate College?

What Degree?

Name of Trade/Business/Other School

Location of Other School

Years Attended Other School

Did You Graduate Other School?

What Degree?

GENERAL INFORMATION

Special Skills/Training

Please list any subjects of special study, research work, special training, skills, etc.

PRESENT & FORMER EMPLOYER #1

Present or Former Employer #1 NAME

Present or Former Employer #1 ADDRESS

Present or Former Employer #1 DATES WORKED (months and years)

Present or Former Employer #1 DETAILS

Please state your position, most recent salary, and reason for leaving

PRESENT OR FORMER EMPLOYER #2

Present or Former Employer #2 NAME

Present or Former Employer #2 ADDRESS

Present or Former Employer #2 DATES WORKED (months and years)

Present or Former Employer #2 DETAILS

Please state your position, most recent salary, and reason for leaving

PRESENT OR FORMER EMPLOYER #3

Present or Former Employer #3 NAME

Present or Former Employer #3 ADDRESS

Present or Former Employer #3 DATES WORKED (months and years)

Present or Former Employer #3 DETAILS

Please state your position, most recent salary, and reason for leaving

PRESENT OR FORMER EMPLOYER #4

Present or Former Employer #4 NAME

Present or Former Employer #4 ADDRESS

Present or Former Employer #4 DATES WORKED (months and years)

Present or Former Employer #4 DETAILS

Please state your position, most recent salary, and reason for leaving

REFERENCES

NAME of Reference #1

DETAILS of Reference #1

Please indicate business, address, and years known

NAME of Reference #2

DETAILS of Reference #2

Please indicate business, address, and years known

NAME of Reference #3

DETAILS of Reference #3

Please indicate business, address, and years known

Authorization

By typing in the date and my name in the box below, 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 to give you any and all information concerning my previous and current employment and any pertinent information they may have, personal and 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. I understand a background check will be required before employment can begin.