Employment Form

Position(s) Applied For:
Date of Application :
How Did You Learn About Us?
AdvertisementFriendWalk-InEmployment AgencyRelativeOther
First Name
Last Name
Middle Name
Email
Street Address
City
State
Zipcode
Country
Main Phone
Other Cell
If you are under 18 years of age, can you provide required proof of your eligibility to work?
YesNo
Have you ever filed an application with us before?
YesNo
If Yes, give date
Have you ever been employed with us before?
YesNo
If Yes, give date
Are you currently employed?
YesNo
May we contact your present employer?
YesNo
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
YesNo
On what date would you be available for work?
Are you available to work:
Full TimePart TimeShift WorkTemporary
Are you currently on “lay-off” status and subject to recall?
YesNo
WTOD requires travel to various Metro-Area Maricopa schools. Do you have reliable transportation?
YesNo
WTOD provides substitute teachers for various Metro-Area Maricopa Schools. Are you willing to work for private, religious based, Montessori, corporate and/or family owned schools?
YesNo
If no, please explain
Have you been convicted of a felony within the last 7 years?
YesNo
Conviction will not necessarily disqualify an applicant from employment.
Are you a veteran?
YesNo
If yes, please explain

EDUCATION


High School


Name and Address of the Schools
Course of Study
Years Completed
Diploma Degree

Undergraduate College


Name and Address of the Schools
Course of Study
Years Completed
Diploma Degree

Graduate Professional


Name and Address of the Schools
Course of Study
Years Completed
Diploma Degree

Other (specify)


Name and Address of the Schools
Course of Study
Years Completed
Diploma Degree

Indicate any foreign languages you can speak, read and/or write


Fluent
Good
Fair
Fluent
Good
Fair
Fluent
Good
Fair
Describe any specialized training, apprenticeship, skills and extra-curricular activities.

EMPLOYMENT EXPERIENCE

Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, or any other legally protected status.


Employer
Street Address
City
State
Zipcode
Country
Telephone Number(s)
Job Title
Supervisor
Reason for Leaving
From
To
Starting
Final
Work Performed

Employer
Street Address
City
State
Zipcode
Country
Telephone Number(s)
Job Title
Supervisor
Reason for Leaving
From
To
Starting
Final
Work Performed

Employer
Street Address
City
State
Zipcode
Country
Telephone Number(s)
Job Title
Supervisor
Reason for Leaving
From
To
Starting
Final
Work Performed

Please disclose any prior employment terminations or other disciplinary action you have received for threats of violence.
List professional, trade, business or civic activities and offices held.

You may exclude membership which would reveal race, color, religion, creed, gender, national origin, age, disability, marital status, veteran status, sexual orientation, or any other legally protected status:

ADDITIONAL INFORMATION


Other Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experience

State any additional information you feel may be helpful to us in considering your application.

Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.

Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the activities involved in the job or occupation for which you have applied? A description of the activities involved in such a job or occupation is attached.
YesNo

References


Name
Phone
Street Address
City
State
Zipcode
Country

Name
Phone
Street Address
City
State
Zipcode
Country

Name
Phone
Street Address
City
State
Zipcode
Country

APPLICANT’S STATEMENT


I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. 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 document 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. I hereby understand that this position is subject to the requirements of either state or federal (DOT) and drug testing rules that the Company may condition any offer of employment upon the successful passing of a drug and alcohol test.