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For Gilpin Court Residents
Volunteer
Team
Contact
STEP Richmond
Donate
Application for Employment
Name
*
First Name
Last Name
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Position you are applying for:
*
How did you learn of this position?
*
Church you attend:
*
Employment Record
Starting with present or most recent, list your two most recent employers. Include self-employment and summer and part-time jobs.
Last or present company:
*
Type of business:
*
Business address:
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Business phone:
*
(###)
###
####
Job title:
*
Brief description of job duties:
*
Manager's name:
*
First Name
Last Name
Base salary:
*
$
Dates worked:
*
From:
MM
DD
YYYY
*
To:
MM
DD
YYYY
Reason for leaving:
*
Previous company:
*
Type of Business:
*
Business address:
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Business phone:
*
(###)
###
####
Job title:
*
Brief description of job duties:
*
Manager's name:
*
First Name
Last Name
Base salary:
*
$
Dates worked:
*
From:
MM
DD
YYYY
*
To:
MM
DD
YYYY
Reason for leaving:
*
Have you ever been convicted of a violation of any federal, state, county, or municipal law, regulation or ordinance?
*
Do not include arrests without conviction or motor vehicle violations for which the only penalty imposed was a fine of $125.00 or less. If yes, please list the date and place of the offense, charge and disposition. Include any conviction as the result of court martials while serving in the military.
Educational History
High School:
*
School location:
*
(City, State)
Dates attended:
*
From:
MM
DD
YYYY
*
To:
MM
DD
YYYY
Graduated?
*
Yes
No
College:
(List all attended)
Major course:
Dates attended:
From:
MM
DD
YYYY
To:
MM
DD
YYYY
Graduated?
Yes
No
Graduate school or other academic achievements:
Please list any special skills you have that would be pertinent to the position:
Military Record
Branch of service:
Present military affiliation:
None
Reserve (active)
Reserve (inactive)
Kinds of training and duty while in service:
References
Please list two professional references and two personal references. Include a reference from your pastor.
Reference #1
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Title/Relationship:
*
Occupation:
*
Reference #2
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Title/Relationship:
*
Occupation:
*
Reference #3
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Title/Relationship:
*
Occupation:
*
Reference #4
Name
*
First Name
Last Name
Phone
*
(###)
###
####
Title/Relationship:
*
Occupation:
*
Signature
*
I hereby certify that the answers and other information on this application are true and correct and that I understand any misrepresentation or omission of facts on my part will be justification for separation from the company's service, if employed. I understand that my employment may be contingent upon receipt of an alien registration number, verification of birth, and any other pertinent information bearing upon my employment and that my continued employment depends upon the will of the company or myself.
First Name
Last Name
Thank you!