Columbus Day News

CHILDREN’S NEST OF MANATEE 5323 26th Street West Bradenton, Fl 34207 (941) 758-8555 EMPLOYMENT APPLICATION All applicants will receive consideration without regard to race, creed, color, sex, age, handicap, or national origin. DATE: NAME (Last, First, Middle) PRESENT ADDRESS (Street, City, State, Zip) PERMANENT ADDRESS (Street, City, State, Zip) PHONE NO. EMAIL ADDRESS ARE YOU 18 YEARS OR OLDER? YES NO HAVE YOU EVER BEEN CONVICTED OF A CRIME? YES NO If yes, explain number of convictions, nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal sex, race, religion, national origin, age, ancestry, handicap, or other protected status: EDUCATION HIGH SCHOOL NAME & ADDRESS YEARS COMPLETED DID YOU GRADUATE? YES NO COLLEGE NAME & ADDRESS YEARS COMPLETED DID YOU GRADUATE? YES NO OTHER NAME & ADDRESS YEARS COMPLETED DID YOU GRADUATE? YES NO SPECIAL SKILLS AND QUALIFICATIONS: EMPLOYMENT EXPERIENCE List below last three employers, starting with the most recent. Please include summer or part-time jobs. DATE EMPLOYER ADDRESS JOB TITLE DATE EMPLOYER ADDRESS JOB TITLE DATE EMPLOYER ADDRESS JOB TITLE REFERENCES Give names of three persons not related to you, whom you have known at least one year. NAME ADDRESS PHONE NUMBER NAME ADDRESS PHONE NUMBER NAME ADDRESS PHONE NUMBER Please read carefully, Initial Each Line, then Sign Below: 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 from all liability for any damage that may result from utilization of such information. I also understand and agree that if I am hired, my employment is for no definite period, regardless of the period of payment, and may, regardless of any dates indicated in this application or subsequently, be terminated at any time without prior notice. Signature of Applicant Date