Application for Employment

Personal Information

Employment Information

Education

Employment Experience

List the most recent experience first

References

Please list three professional references below:

Additional Experiences:

Equal Employment Opportunity Policy

It is the policy of Two Rivers Head Start Agency to afford equal opportunity regardless of race, religion, color, national origin or sex. Further, all applicable laws relating to age, marital status, and handicap discrimination will be strictly adhered. This policy of Equal Opportunity applies to all aspects of the employment relationship. In accordance with Company policy and applicable law, Two Rivers Head Start Agency maintains an Affirmative Action Program with respect to its Equal Employment objectives. Questions concerning Equal Employment Opportunity or Affirmative Action should be referred to the EEO Officer.

Applicant Acknowledgement

I certify that the 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 many times necessary in arriving at an employment decision. I authorize Two Rivers Head Start Agency to contact my previous/current employers and/or any references listed. This application for employment shall be considered active for a period of time not to exceed one (1) year. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with Two Rivers Head Start is of an "at will" nature, which means that the employee may resign at any time and the agency may discharge the 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 changes specifically acknowledged in writing by an authorized executive of the agency. Employment offer may be made contingent to applicant passing a job-related physical exam including TB test, pre-employment drug test, and a Department of Justice fingerprint clearance or exemption and receipt of a photo I.D. 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.