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Employment Form

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability, medical condition, sexual orientation, or other protected classifications.

Please carefully read and answer all questions. You may not be considered for employment if you fail to completely answer all the questions on this application. You may attach a résumé, but all questions must be answered. Reasonable accommodation to complete AFWD’s application process is available by contacting the EEO Officer at (530) 283-9621.

Personal Information

Position Information

Check all that you are willing to work.

Qualifications

Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges, degrees, vocational or technical programs, and military training.

High School

College

Vocational/Other

Please list any special skills or experience that you feel would help you in the position that you are applying for.

References

Please list three professional references not related to you, with full name, address, phone number, and relationship.  If you don’t have three professional references, then list personal, unrelated references.

Reference #1

References (cont.)

Reference #2

References (cont.)

Reference #3

Work History   

Start with your present or most recent employment and work back.  Use a separate sheet if necessary.

Work History (cont.)

Work History (cont.)

Work History (cont.)

Please read each statement below carefully, initial after each, and ellectronically sign your name at the bottom of this page.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and AFWD. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or AFWD, and that no promises or representations contrary to the foregoing are binding on AFWD unless made in writing and signed by me and AFWD’s designated representative.

Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by AFWD, I am entitled to copies of any such public records obtained by AFWD unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.

Voluntary EEO Survey

Completion of this form is entirely voluntary, and all information will remain confidential and will not affect your application for employment.  Alliance for Workforce Development, Inc is an Equal Opportunity Employer.  This document is for EEO reporting purposes only.  It will not become part of your personnel record if you are hired by this company.

The employer, Alliance for Workforce Development, Inc, is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations.  In order to comply with these laws, the employer invites you to voluntarily self-identify your race or ethnicity.  Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify any specific individual.