Employment

Position Applying For*

Date*

Personal Information

Full Name (First + Middle + Last)*

Permanent Address*

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone*

Email*

Date of Birth*

Do you have the legal right to live and work in the U.S.?*

Yes
No

United States Visa status, if applicable*

Have you been arrested?*

Yes
No

Have you ever been convicted of a felony, misdemeanor or received deferred adjudication including sex related or child abuse related offenses? If so please explain:

If yes, list dates, offenses, and disposition.

Convictions are not an automatic disqualification from employment.

Have you had any traffic accidents or citations in the last 5 years? If so, please give date and offense.*

date	Offense

Driver License*

Do you have a Valid Driver License?

Yes
No

Are you at least 18 years old?*

Yes
No

Are you at least 21 years old?*

Yes
No

Position Information

Position Applying For*

Salary desired ($)*

Date Available*

Type of Employment You Are Seeking:*

Full Time
Part Time
Temporary

What hours are you available to work?

How did you hear about this job?*

Employment History (Most Recent First)

Give employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work.

Job Title (Most Recent)

Company Name

Duties

Dates Employed

From	To

Salary Information

Starting Salary	Ending Salary	Employment Status (Full Time, Part Time, or Temporary)

Employer's Address

Employer Contact

Supervisor Name	Phone Number	May we contact?

Reason for Leaving

Job Title (Second Most Recent)

Company Name

Duties

Dates Employed

From	To

Salary Information

Starting Salary	Ending Salary	Employment Status (Full Time, Part Time, or Temporary)

Employer's Address

Employer Contact

Supervisor Name	Phone Number	May we contact?

Reason for Leaving

Job Title (Third Most Recent)

Company Name

Duties

Dates Employed

From	To

Salary Information

Starting Salary	Ending Salary	Employment Status (Full Time, Part Time, or Temporary)

Employer's Address

Employer Contact

Supervisor Name	Phone Number	May we contact?

Reason for Leaving

Job Title (Fourth Most Recent)

Company Name

Duties

Dates Employed

From	To

Salary Information

Starting Salary	Ending Salary	Employment Status (Full Time, Part Time, or Temporary)

Employer's Address

Employer Contact

Supervisor Name	Phone Number	May we contact?

Reason for Leaving

Education

Where did you attend high school & college? (Click the + button to add a new row)*

School Name & Address	Dates Attended	Degree/Dipoloma Received	Subject Studied	Did you graduate?

Special courses, training or experience acquired, including military experience.

Skills

Clerical / Office skills

Computer skills

Name of Software	Platform (PC, Mac, WPM)

Languages

Other special knowledge or skills

Please describe any other experience, abilities or skills that might be helpful in considering your application.

Personal Refferences

Refferences

Name	Address	Phone

CERTIFICATION & AUTHORIZATION

Camp Fire is a Zero Tolerance facility for child abuse, All actions will be monitored for the safety of your children.

I hereby certify that all statements made in this application are true and correct to the best of my knowledge and belief. I understand that any misrepresentations or omissions of facts in this application are grounds for disqualification from further consideration or for dismissal from employment. I authorize the company to inquire into my educational, personal, professional and past employment history reverences as needed to research my qualifications for this position. If employed, I agree to conform to the rules, regulations and policies of the company. I understand that I will be an employee “at will” and either the company or I may terminate my employment relationship at any time for any reason not in violation of law. I hereby acknowledge that I have read and fully understand the forgoing and seek employment under these conditions.

Digital Signature:*

Printing your First Name + Middle Initial + Last Name will act as your digital signature.

Date*

Camp Fire is now hiring for our After School Program!!

The after school program begins at the end of August. There is a training week scheduled for August 22nd, so put in your application now!

We are looking for positive and energetic people to join our team for our After School youth program that serves elementary and junior high ages from all backgrounds. Our mission is to build caring, confident youth and future leaders.

Applicants must be 20+ years to apply and have a clean driving record. Hours of work are Monday through Friday 2:00pm to 7:00. Pay is $12/hr.

Employment Application

Personal Information

Position Information

Employment History (Most Recent First)

Education

Skills

Personal Refferences

CERTIFICATION & AUTHORIZATION

Camp Fire is a Zero Tolerance facility for child abuse, All actions will be monitored for the safety of your children.