Employment Application - Loving Arms Center

Loving Arms Learning Center Employment Application

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age,
disability, marital or veteran status, sexual orientation, or any other legally protected status.

1.) Take the Job fit Assessment by going to www.kansas.jobfit.com and complete the brief survey.
Be sure to include the date and time of completion of the Kansas Job Fit survey with your employment
application submission.

2.) Complete the application below. There are seven pages to be completed.

Personal Data

Postion Applying For: * Please input the position you are interested in.
How did you learn about Loving Arms Learning Center?
e-Mail Address * Please enter a valid email address
Telephone Number and Cell Phone
Last 4 of Social Security Number *

I understand that I will be required upon request to furnish my complete Social Security Number to be eligible for employment. *
I acknowledge my understanding.

Please answer the following:
If you are under 18 years of age, can you provide required proof of your eligibility to work? *N/ANoYes
Have you ever applied with us before? *YesNo
If yes, please enter date:
Are you currently employed? *YesNo
May we contact your current employer? *N/ANoYes
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? *YesNo
If yes, what date would you be able to work?
Are you available to work:
Are you currently on lay-off status and subject to recall?YesNoN/A
Have you ever been convicted of a felony or misdemeanor in the last 7 years? * Conviction will not necessarily disqualify you from employment.YesNo
If yes, please explain: Please be as specific as possible.

Education
Elementary School Name and Address
Elementary Course of Study
Elementary Years Completed
High School Name and Address
High School Course of Study
High School Years Completed
High School Graduate
Undergraduate School Name and Address
Undergraduate School Course of Study
Undergraduate School Years Completed
Undergraduate School Degree
Graduate / Professional School Name and Address
Graduate / Professional School Course of Study
Graduate / Professional School Years Completed
Graduate / Professional School Degree
Other School Name and Address
Other School Course of Study
Other School Years Completed
Other School Degree or Certificate

Language Information
What is your native language? * This is the language most frequently spoken in your home.
Speak Foreign Language(s) Please list languages you are proficient in.
Write Foreign Language(s) Please list languages you are proficient in.
Read Foreign Language(s) Please list languages you are proficient in.
Describe any job related specialized traing, apprenticeships, skills, and extra-curricular activites:
Describe any job related training in the United States military:

Employment History

1. Employer
Employer Name
Employer Address
Employed From Date:
Employed To Date:
Employer Telephone
Supervisor's Name
Job Title
Beginning and Ending Hourly Rates
Reason for Leaving:
Work Experience:
2. Employer
Employer Name
Employer Address
Employed From Date:
Employed To Date:
Employer Telephone
Supervisors Name
Job Title
Beginning and Ending Hourly Rates
Reason for Leaving:
Work Experience:
3. Employer
Employer Name
Employer Address
Employed From Date:
Employed To Date:
Employer Telephone
Supervisors Name
Job Title
Beginning and Ending Hourly Rates
Reason for Leaving:
Work Experience:
Additional Information:
List any professional, trade, business or civic activities and offices held. You may exclude memberships which would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status.
Other Qualifications
Additional Specialized SkillsCRTPCCalculatorTypewriterWord PerfectPBX SystemFaxLotus 1-2-3Microsoft WordMicrosoft Excel
Production or Mobile Equipment:
Other skills you feel are relevant:
State any additional information you feel would be helpful in our review of 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 reasonable accomodation, the activities in the job or occupation for which you have applied? Do not answer this question unless you have been informed about the requirements of the job for which you are applying.N/ANoYes

References

Reference 1 Name *
Reference 1 Telephone *
Reference 2 Name
Reference 2 Telephone
Reference 3 Name
Reference 3 Telephone

I certify that the answers given are true and complete to the best of my knowledge. I authorize the investigation of all statements contained in this application for employrnent as may be necessary in arriving at an employment decision. I also understand that I must clear a SRS and KBI background check. This application for employment shall be considered active for a period of time not to exceed Six (6) months. Any appiicant 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 the Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not change by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. ln 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 regulalions of the employer.
By typing in your name below, you acknowledge that you are electronically signing the above declaration of understanding.

Signed Electronically By typing in your name, you acknowledge that you are electronically signing the application.
On this date:
Job Fit Survey Completion Date and Time:

Type the following: For security purposes, please type the letters in the image.