Employment Application

Applications are considered without regard to race, color, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.

Personal Information

Your Name

Address

City

State

Zip

Day Telephone

Evening Telephone

Your Email

Social Security Number



Are you 18 years of age or older?



Have you ever been convicted of or charged with a felony or misdemeanor?

If yes, please explain details in full, including dates, details of offense(s) charged, jurisdiction and disposition of case.



Employment Desired (Selectall that apply)

Position Desired

Date Available

Referred By


Education

Please list Schools/Colleges Attended.

High School Name

Years Attended Graduation Year Degree

School 2 Name

Years Attended Graduation Year Degree

School 3 Name

Years Attended Graduation Year Degree

School 4 Name

Years Attended Graduation Year Degree


Special Skills

Describe any special skills or qualifications for this work.


Employment/Work Experience

Start with your present or most recent position. Include military service assignments and volunteer activities. Exclude organization names that indicate race, color, religion, sex or national origin.


Company 1 Name

Address

City

State

Zip

Your Supervisor

Phone

Email

Your Job Title

Describe Duties/Responsibilities/Accomplishments

Dates of Employment (MM/YYYY):
From to

Reason for Leaving


Company 2 Name

Address

City

State

Zip

Your Supervisor

Phone

Email

Your Job Title

Describe Duties/Responsibilities/Accomplishments

Dates of Employment (MM/YYYY):
From to

Reason for Leaving


Company 3 Name

Address

City

State

Zip

Your Supervisor

Phone

Email

Your Job Title

Describe Duties/Responsibilities/Accomplishments

Dates of Employment (MM/YYYY):
From to

Reason for Leaving


Personal References

Please provide names, addresses, phone numbers, relationship and how long known for three personal references.


Reference 1 Name

Address

City

State

Zip

Phone

Email

Describe Relationship

Length of Relationship


Reference 2 Name

Address

City

State

Zip

Phone

Email

Describe Relationship

Length of Relationship


Reference 3 Name

Address

City

State

Zip

Phone

Email

Describe Relationship

Length of Relationship


Cover Letter / Resume Upload

Your Message (Type cover letter here or include in resume upload.)

Upload your resume here (Up to 300kb .doc, .docx, .odt, .pdf or .rtf files permitted)


Certification

I CERTIFY that the above answers are true and complete to the best of my knowledge. I authorize City Mission of Schenectady, to investigate any statement contained in this application, and to obtain a credit report and/or background check on me as necessary to determine my qualifications. I understand that this application is not and is not intended to be any kind of contract or agreement and that any employment relationship with this organization is of an “at will” nature. In the event of employment, I understand that any false or misleading information given in my application, correspondence, discussions or interview may result in immediate termination. I understand also, that I am required to abide by all rules, regulations and policies of City Mission of Schenectady.


(Certification required for submission)