Partnerships with Industry Employment Application

Employment Application

Position Applying For: How Referred: Date:

Name (first, middle, last):

Address:

City: State: Zip:

Personal email: l a Home ph: ( ) Message ph: ( ) n o Are you legally eligible for employment in the United States? □ Yes □ No s r e Have you or any family member ever been employed by the Big Sister League of San Diego? □ Yes □ No P Are you 18 or over? □ Yes □ No Valid driver’s license? □ Yes □ No State/date of expiration: / work phone: am May we contact you at work? □ Yes □ No □ N/A If yes, # and best time to call: : ( ) Pm Date available: Hours per week expected: Pay expected:

Type of employment you are seeking: □ Full Time □ Part Time □ On Call e l

b Specific Mo Tu We Th Fr Sa Su a l i Days/Hrs Beg a

v Available: End A

n o i t a c u d E

g n i n i a r T / s l l i k S / r e h t O

Big Sister League of San Diego, Inc. Employment Application 1.High Employer: School: Phone ( )

City/St/Zip Diploma Yes No Address: May we contact:: □ Yes □ No □ □

City/St/Zip:College/Univ: e c DatesField of employed: study: Begin salary:Years Attended: End Salary: n

e Title: Hours/week: i City/St/Zip Degree □ Yes □ No r Duties: e Other, or additional education. Please attach credentials, special trainings/qualifications, etc.: p x

E Supervisor’s name & title:

/ Computer knowledge/experience/proficiency level (please be specific): Reason(s) for leaving: d

n 2. Employer: Phone ( ) u Typing/keyboard skills speed (words per minute, 10key, etc.): o Address: May we contact:: □ Yes □ No r g City/St/Zip: k Foreign Language(s) as applicable to the job (e.g., Sign Lang and Braille, etc.) and relevant proficiency level: c Dates employed: Begin salary: End Salary: a Title: Hours/week: B Current active professional licenses/certifications. Please attach certificates, etc.: t Duties: n e

m Supervisor’s name & title: y Reason(s) for leaving: o l

p 3. Employer: Phone ( ) m Address: May we contact:: □ Yes □ No E

t City/St/Zip: n Dates employed: Begin salary: End Salary: e c Title: Hours/week: e

R Duties:

Supervisor’s name & title:

Reason(s) for leaving:

Have you ever been involuntarily discharged from any employment: □ Yes □ No If yes, explain:

Big Sister League of San Diego, Inc. Employment Application BACKGROUND INFORMATION

Have you ever been convicted of, or pled no contest to, a felony? In answering this question, the following convictions do not require a "yes" response: (1) a marijuana-related conviction that occurred more than two years ago, (2) an offense for which you were referred to, and participated in, a pre or post-trial diversion program, or (3) a conviction that has been expunged.

□ Yes □ No s Note: A conviction will not necessarily disqualify you from employment. Each case is considered on its own merits n

o If yes, list date, city, state and nature of all felony offenses. If you need additional space, please use another piece of paper. i t c i v n o Have you used names other than the name listed on your application?: □ Yes □ No C

If yes, please list names:

y MILITARY SERVICE r a Branch of service: Dates of service: t i l i Duties/special training: M

REFERENCES

Ref 1. (First/Last): Phone:

Address:

City/St/Zip:

Relationship: Time known: s Ref 2. (First/Last): Phone: e c Address: n

e City/St/Zip: r

e Relationship: Time known: f e Ref 3. (First/Last): Phone: R

Address:

City/St/Zip:

Relationship: Time known:

Big Sister League of San Diego, Inc. Employment Application Application Acknowledgement BIG SISTER LEAGUE OF SAN DIEGO, INC.

By my signature,

 I understand that employment with Big Sister League of San Diego, Inc. (BSL) requires that I submit to fingerprinting and a tuberculosis test as a condition of my employment.  I understand that employment with BSL is contingent upon successful completion of a post-offer physical examination, DMV record, drug testing, reference check, credential review, credit standing and/or criminal background investigation if BSL determines that such an examine, test, or investigation is appropriate for the position I have applied for.  I understand that incomplete or incorrect information will result in my ineligibility for employment or termination of my employment if it is discovered after I am hired.  I authorize BSL to substantiate and verify my past employment, previous salary history, professional credentials, credit standing, and academic degrees, and to obtain information from references. I agree to release BSL from any liability arising from its efforts to obtain information from references and verify the information I provide to it in this application or separately, as well as BSL’s use of such information in determining my eligibility for employment.

 I authorize my previous schools, employers, listed references, and others who have information about me, to release to BSL or its appointed investigative agencies, any relevant information, including transcripts, that may be requested in connection with my employment. I agree to release any previous employers, schools, and personal or professional references from any liability arising from or relating to information that they may provide about me to BSL.

 I understand that if I submit a résumé or any other document as requested during the application process, by signing this application I am certifying that all information contained in the résumé or other document is complete, true, and accurate.

 I understand and agree that, if hired, my employment with BSL is at-will, meaning that it is for no definite period and may be terminated at any time without prior notice and without cause. I also understand that the at-will nature of the employment relationship is the entire agreement regarding the nature and duration of my employment and cannot be changed except in a writing signed by BSL’s President/CEO, which expressly states that it is changing the at-will nature of the employment relationship.

 I understand that this application does not represent a contract, nor does it guarantee that I will be hired.

 I understand that this application is considered current for thirty (30) days. If I wish to be considered for employment at a later time, I must renew and update my application at that time.

Applicant’s signature Date

Big Sister League of San Diego, Inc. Employment Application