Please Complete All Sections

APPLICATION

Please complete all sections

Disability Rights Oregon Information and Referral Assistant Position

Please submit a letter of interest, a copy of your resume, and a completed application form (available at http://www.droregon.org/about-us/employment). Interviews will begin as resumes are received and qualified candidates identified. The application period will close when the position is filled. Applications must be received by email at: [email protected]. If you need to submit your application in an alternate format, please contact us at [email protected] or 503-243-2081.

A. Personal Information Name

Address

Telephone/Email

B. Education/Training Years of School Completed School Attended, Degrees Earned, and Years Obtained

Other Relevant Training

Relevant Volunteer Activities

of 5 C. Work History (Put current position first and then previous positions) Employer Name, Address, Phone Dates of Employment

Position

Reason for Leaving

Primary Responsibilities

May We Contact: Yes No

Employer Name, Address, Phone Dates of Employment

Position

Reason for Leaving

Employer Name, Address, Phone Dates of Employment

Position

Reason for Leaving

Please add separate sheets for additional employers.

D. Please use a check box below to tell us your level of proficiency in each of the following languages. Add additional languages as needed.

English Level 1 – Elementary – Can fulfill the basic needs in a language, such as ordering meals, asking time, and asking for directions. Level 2 – Limited Working Proficiency – Can fulfill routine social demands, such as small talk about one’s self, one’s family, and current events. Level 3 – Professional Working Proficiency – Can discuss a variety of topics with ease and almost completely understand what others are saying. Level 4 – Full Professional Proficiency – Can participate in all manners of conversations with ease and only rarely makes grammatical mistakes. Level 5 – Native or Bilingual Proficiency – Can use the language the way an educated native speaker of the language would.

Spanish Level 1 – Elementary – Can fulfill the basic needs in a language, such as ordering meals, asking time, and asking for directions. Level 2 – Limited Working Proficiency – Can fulfill routine social demands, such as small talk about one’s self, one’s family, and current events. Level 3 – Professional Working Proficiency – Can discuss a variety of topics with ease and almost completely understand what others are saying. Level 4 – Full Professional Proficiency – Can participate in all manners of conversations with ease and only rarely makes grammatical mistakes. Level 5 – Native or Bilingual Proficiency – Can use the language the way an educated native speaker of the language would.

Other Language (Please Specify) Level 1 – Elementary – Can fulfill the basic needs in a language, such as ordering meals, asking time, and asking for directions. Level 2 – Limited Working Proficiency – Can fulfill routine social demands, such as small talk about one’s self, one’s family, and current events. Level 3 – Professional Working Proficiency – Can discuss a variety of topics with ease and almost completely understand what others are saying. Level 4 – Full Professional Proficiency – Can participate in all manners of conversations with ease and only rarely makes grammatical mistakes. Level 5 – Native or Bilingual Proficiency – Can use the language the way an educated native speaker of the language would.

of 5 E. Please use a check box below to tell us your level of expertise in each of the following software programs and technologies. Add additional as needed. Note: be honest: we don’t expect you to be an expert on everything!

Level of Expertise Name of software/technology None Basic Average Advanced Microsoft Word Microsoft Excel Microsoft PowerPoint Microsoft Outlook Gmail Google Drive Google Calendar Adobe Acrobat SurveyMonkey Skype or other virtual meeting program, please specify:

Database, please specify:

Web design platform, please specify:

Multi-line phone systems Multi-function copiers Postage machines Troubleshooting PC’s

F. Do you possess any special skills which would be considered valuable in this job? (e.g. medical, education or social service training)

G. Is there anything else you would like us to consider in reviewing your application?

of 5 H. References

Please list 3 professional references (supervisors preferred):

Relationship, Email address, address, and Name # of years phone number

I declare that the information contained in the above application is complete and true.

______Signature and Date