Application for Employment

Application for Employment
Applicant Information
Name:*

First NameLast Name
Current Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long will you be at your current address?
Click here if your permanent address is the same as your current address.

Same
Permanent Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number:*

Area CodePhone Number
Other Phone Number:

Area CodePhone Number
Email:
example@example.com
Facebook Profile Link:
Other names used during prior employment (maiden,surname ect.)
What type of position are you seeking for employment?
Are you at least 16 years old?*
Are you at least 18 years old?*
Are you a citizen of the United States?*
If no, are you authorized to work in the United States?*
Have you ever been convicted of a felony?*
If Yes, please explain:
Have you ever been convicted of a felony?
Have you ever been convicted of a crime in which a child was a victim?*
If Yes, please explain:
Have you ever been convicted of a crime in which a child was a victim?
Have you worked at 4-H Camp Ohio before?*
If Yes, what was your position?
Have you worked at 4-H Camp Ohio before?

Former Employers

(List below the last 3 employers, starting with most current.)
1.) Company Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
Job title and responsibility:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for leaving:
Ending salary:
Name of Supervisor:
May we contact them as a reference?
2.) Company Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Job title and responsibility:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for leaving:
Ending salary:
Name of Supervisor:
May we contact them as a reference?
3.) Company Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
Job title and responsibility:
Start Date:

MonthDayYear
Date
End Date:

MonthDayYear
Date
Reason for leaving:
Ending salary:
Name of Supervisor:
May we contact them as a reference?

References

(Please list 3 people who you are not related to you, references will be checked)
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*

Area CodePhone Number
Email:
example@example.com
How do you know this person and for how long?*
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*

Area CodePhone Number
Email:
example@example.com
How do you know this person and for how long?*
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*

Area CodePhone Number
Email:
example@example.com
How do you know this person and for how long?*

Authorization
Background Check Authorization (I understand that choosing no, this option makes me ineligible for hire.)*

Yes, I authorize 4-H Camp Ohio to do a background check.No, I do not authorize 4-H Camp Ohio to do a background check.
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company front all liability for any damage that may result from utilization of such information. I authorize investigation of all statements herein and release the camp and all others from liability in connection with it. I understand that, if employed, I will be an at-will employee and that any agreement to the contrary must be in writing and signed by the director of the camp. I also understand that untrue, misleading, or omitted information herein may result in dismissal, regardless of the time of discovery by the camp.
By checking this, you are signing this electronically*

I agree.
Resume

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