Allegany County Human Resources Development Commission, Inc

Friends Aware, Inc. Applicant Instruction Sheet

Thank you for your interest in employment opportunities with Friends Aware, Inc. Attached you will find an Application for Employment and 3 Reference Check sheets which need to be completed before we can consider you for any of our open positions. Please keep the requirements below in mind as you complete them to ensure timely review of your information and to assist us in considering you for the most suitable position(s). Application for Employment - Complete all areas. If something is not applicable to you, list “N/A”. Incomplete applications may delay processing.

- Specify which position(s) at Friends Aware that you are interested in. Current openings, or positions for which we regularly accept applications, are posted in the Friends Aware Administration Bldg. lobby at 1601 Holland St., Cumberland, MD.

- Do not list relatives for references.

Reference Sheets - Please make three-(3) copies of this form since we require three-(3) references.

- Print clearly. Illegible forms may delay processing of your application.

- Complete top section only as follows:

o Name, address & phone of your reference. (Name of Business if work-related)

o Type of reference

o Your printed name

o Any and all positions for which you are applying

o Your signature and date. Do not complete anything below your signature.

- If you have work experience, at least one sheet must contain a work-related reference such as a previous supervisor or someone who can attest to your ability to perform the functions of your job or the job for which you are applying.

Employment inquiries are reviewed on an ongoing basis. If you are selected for an interview, you will be contacted to schedule one. If you are not selected right away, your information will be retained for a period of 12 months from the date it was submitted and you may be considered for future openings as they arise. Any questions regarding this process may be directed to Friends Aware Human Resources Department. You may either email the application and reference check forms to [email protected], mail them or submit them in person at 1601 Holland St., Cumberland, MD 21502. ** Please keep this sheet for your records. ** Employment Application Applicant Information Dat Full Name: e: Last First M.I. Address: Street Address Apartment/Unit #

City State ZIP Code Phone: ( ) E-mail Address:

Date Available: Position Applied for: YES NO Are you over the age of 18 ? If no, you may be required to provide authorization to work. How did you hear about the Agency (Circle One)? Newspaper Job Service Internet Friend Current Employee (name)

YES NO YES NO Are you a citizen of the United States? If no, are you authorized to work in the U.S.? YES NO Have you ever worked for this Agency? If so, when? YES NO Have you ever been convicted of a felony?

If yes, explain:

Have you had a valid driver’s license for a YES NO If yes, have you had 2 or more moving YES NO minimum of 3 years? violations in the past 3 years?

Education

High School: Address: YES NO Did you graduate? Degree:

College: Address: YES NO Did you graduate? Degree:

Other: Address: YES NO Did you graduate? Degree:

References Please list three professional/personal references.

Full Name: Relationship:

Company: Phone: ( )

Full Name: Relationship: Company: Phone: ( )

Full Name: Relationship:

Company: Phone: ( )

Previous Employment

Company: Phone: ( )

Address: Supervisor:

Job Title: Starting Salary: $ Ending Salary: $

Responsibilities:

From: To: Reason for Leaving: YES NO May we contact your previous supervisor for a reference?

Company: Phone: ( )

Responsibilities:

From: To: Reason for Leaving: YES NO May we contact your previous supervisor for a reference?

Company: Phone: ( )

Responsibilities:

From: To: Reason for Leaving: YES NO May we contact your previous supervisor for a reference? Military Service

Branch: From: To:

Rank at Discharge: Type of Discharge:

If other than honorable, explain: Disclaimer and Signature

I certify that the answers given herein are true and complete to the best of my knowledge. I also authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written documentation or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Employer.

It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State or Local law.

Signature: Date: FRIENDS AWARE, INC.

APPLICANT/NEW HIRE REFERENCE CHECK

Reference Type (check one): Reference Name: Address: Work Reference  Personal Reference  Phone: Educational Reference 

Name of Business (if work reference):

Applicant’s Name:

Position Applied for:

I hereby authorize the release of the information requested:

Applicant’s Name Signature Date:

(APPLICANT: DO NOT WRITE BELOW THIS LINE)

Name of Person Responding: Title:

Company: Phone No.: ( )

Applicant’s Employment Dates: From: To:

Applicant’s Position/Title:

Reason(s) for Leaving:

Eligible for Rehire? Yes  No  Explanation

Strong Points Areas of Improvement

Signature of Respondent Date

SEE REVERSE FOR PERSONAL AND EDUCATIONAL REFERENCES PERSONAL REFERENCE

How well do you know the applicant? Slightly  Well  Very Well 

Years known? Relationship to applicant: (Relative, friend, etc.) Have you had contact with applicant in the past 12 months? Yes  No 

Please rate the applicant Above Below No on the following Average Average Averag Knowledge e APPEARANCE     DEPENDABILITY     HONESTY     INITIATIVE     JUDGMENT     MATURITY    

EDUCATIONAL REFERENCE

Degree/Course/Certification:

Completion Date: Graduated Yes  No  ?

Comments/Faculty Evaluation:

Signature of Respondent Title Date

MAILING INSTRUCTIONS:

Please return this Reference Check to:

Human Resources Department (Name of Person Requesting Reference Check)

Friends Aware, Inc. 1601 Holland Street Cumberland, MD 21502 FRIENDS AWARE, INC.

Applicant’s Name:

Friends Aware, Inc. 1601 Holland Street Cumberland, MD 21502 FRIENDS AWARE, INC.

Applicant’s Name:

Friends Aware, Inc. 1601 Holland Street Cumberland, MD 21502