To applicant: We deeply appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will aid us in placing you in the position that best meets your qualification.

Today's Date

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Position Applied For

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Rate of Pay Expected Per Hour

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Name

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Present Address

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Home Phone

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Cell Phone

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Social Security Number

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Are you legally eligible for employment in the USA? (Proof of U.S. citizenship or immigration status will be required upon employment)

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State age if under 18

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Have you ever been employed here before?

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If yes, when were you last employed here? What position?

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Hours and days available

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If selected, on what date will you be able to work?

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Have you been convicted of a crime other than a traffic violation?

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If yes, please explain

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Criminal convictions are not an absolute bar to employment, but will be considered in relation to specific job requirements.

Are you able to meet the attendance requirements of the position?

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May we contact your current employer?

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EMPLOYMENT HISTORY

From

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Employer

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Phone

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Job title

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Wage

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Address

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Name of Supervisor

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Summarize the nature of work and job responsibilities.

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Reason for leaving:

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List previous two (2) employers, starting with the most recent, including military experience:

Job {binding ItemNumber}

From:

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To:

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Employer:

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Phone

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Job Title:

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Wage:

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Address:

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Name of Supervisor:

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Summarize the nature of work and job responsibilities:

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Reason for leaving:

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SKILLS AND QUALIFICATIONS:

Summarize special skills and qualifications acquired from employment or other experiences that may qualify you to work for us:

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EDUCATIONAL BACKGROUND

High School

Name and location of High School:

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Years completed:

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Did you graduate?

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College

Name and location of college

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Years completed:

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Did you graduate?

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Major:

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Degree:

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Course of Study:

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OTHER

Name and location:

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Years completed:

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Did you Graduate?

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Any other information:

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PERSONAL REFERENCES (not former employees or relatives)

REFERENCE 1

Name:

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Phone:

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Years Known:

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REFERENCE 2

Name:

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Phone:

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Years known:

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REFERENCE 3

Name:

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Phone:

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Years Known:

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How did you hear about this position?

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If employee referral, who was it?

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List any friends or relatives working for us:

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PLEASE READ AND SIGN BELOW

Mennonite Friendship Communities (mfc) has a policy of pre-employment screening for the use of illegal drugs and substance abuse. All offers of employment are continent on submission to this company’s drug/alcohol screening procedure and a “negative” drug test result. Any contingent offer of employment will be withdrawn if the applicant tests positive for any illegal drugs or substance abuse.

I understand that according to federal law all individuals who are hired must, as a condition of employment, produce certain documentation to verify their identity and U.S. citizen status, or if not, their legal authorization to work in the U.S. As a consequence, I understand that any offer of employment would be continent on my ability to produce the required documentation within the first 3 days of employment.

I give mfc the right to investigate all personal history and references from former employers, pertinent to my employment. I hereby release from liability mfc and its representatives for seeking such information, and all other persons, corporations, or organizations from furnishing such information.

I hereby certify that the information set forth in my application for employment is true and complete. I understand that false or incomplete statements on this application shall be considered grounds for disqualification for employment or sufficient cause for dismissal.

This application is current for only 60 days. After this time, if I have not heard from mfc and still wish to be considered for employment, it will be necessary to fill out a new application.

MFC is an Equal Opportunity Employer and does not discriminate in employment. We recruit, select, hire, transfer, place and promote for all job classifications without unlawful discrimination based on race, color, religion, sex, age, national origin, ancestry, disability, veteran status, genetic information, or any other unlawful reason. We make all decisions on employment based solely on an individual’s qualifications related to the position being filled. No question on this application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state, or federal law.

I understand that just as I am free to resign at any time, mfc reserves the right to terminate my employment at any time with or without cause and without prior notice. I understand that no representative of mfc has the authority to make assurances to the contrary.

Signature

Today's Date

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Send us your resume:

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EMPLOYMENT HISTORY

List previous two (2) employers, starting with the most recent, including military experience:

Job {binding ItemNumber}

SKILLS AND QUALIFICATIONS:

EDUCATIONAL BACKGROUND

High School

College

OTHER

PERSONAL REFERENCES (not former employees or relatives)

REFERENCE 1

REFERENCE 2

REFERENCE 3

PLEASE READ AND SIGN BELOW

EMPLOYMENT HISTORY

List previous two (2) employers, starting with the most recent, including military experience:

Job {binding ItemNumber}

SKILLS AND QUALIFICATIONS:

EDUCATIONAL BACKGROUND

High School

College

OTHER

PERSONAL REFERENCES (not former employees or relatives)

REFERENCE 1

REFERENCE 2

REFERENCE 3

PLEASE READ AND SIGN BELOW

Your progress has been saved.

EMPLOYMENT HISTORY

List previous two (2) employers, starting with the most recent, including military experience:

Job {binding ItemNumber}

SKILLS AND QUALIFICATIONS:

EDUCATIONAL BACKGROUND

High School

College

OTHER

PERSONAL REFERENCES (not former employees or relatives)

REFERENCE 1

REFERENCE 2

REFERENCE 3

PLEASE READ AND SIGN BELOW