Application

Employment Application

Note: Fields marked with a * require an answer. Please use "N/A" for "not applicable" if necessary. Applicants may be required to complete and sign a paper application for employment upon interview.
Attach Resume:
*Email:
*Position Applied for:

Applicant Information

*First Name: *Last Name: MI:
*Address: Apartment/Unit #
*City *State
*Zip
*Phone: Referred By:
Date Available:

Salary Expected:
*SSN: I can work:  Weekends    Evening    Night
U.S. Citizen:    Yes    No If not, are you authorized to work in the U.S.?:  Yes     No
Languages Spoken: Driver's License No:      State: 
*Have you ever worked for this company?:  Yes     No If yes, when?:  to   (mm/dd/yyyy)
*Have you ever been convicted of a felony?
(By company policy some misdemeanors may bar employment):
 Yes     No If yes, explain briefly:

Education

High School:   Address:
Graduate:    Yes     No   Degree:
College:   Address:
Graduate:    Yes     No   Degree:
Other:   Address:
Graduate:    Yes     No   Degree:

References

Please list three references not related to you, whom you have known at least one year.
Name: Occupation:
Company: Day Phone Numbers:
Address:
Name: Occupation:
Company: Day Phone Numbers:
Address:
Name: Occupation:
Company: Day Phone Numbers:
Address:

Employment History for Last 10 Years

Please account for any periods of unemployment.
Company Name: Complete Address
(w/ City, State, Zip):
Phone: Supervisor:
Job Title: Responsibilities:
Starting Salary: Ending Salary:
Start Date:
(mm/dd/yyyy)
End Date:
(mm/dd/yyyy)
Reason for Leaving: May we contact your previous employer for a reference?  Yes    No


Application Agreement

Please read and sign the following employment agreement

I hereby affirm that all information in this application is true and accurate to the best of my knowledge. I understand that the college can obtain criminal history record information on applicants for employment. Pursuant to the requirements of the Fair Credit Reporting Act, notice is given that a consumer report+ may be made in connection with your application for employment. I understand that any misrepresentation or falsification of this record or failure to disclose conviction for a felony or for any offense involving moral turpitude will be considered cause for dismissal. If you are denied employment, either wholly or partly, because of information contained in a consumer report, a disclosure will be made to you of the name and address of the consumer-reporting agency making such report.

Signature below verifies you have read the above notice and understand what it means.

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This institution is an equal opportunity provider and employer. Jarvis Christian College is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools to award the baccalaureate degree. For information concerning regional accreditation, contact: Commission on Colleges, Southern Association of Colleges and Schools, 1866 Southern Lane, Decatur, Georgia 30033-4097, Telephone: 404-679-4500, Fax: 404-679-4558, www.sacscoc.org