Personal InformationDate *Name *Street Address *Apartment, suite, etcCityStateZIPEmail Address *Cell Phone *Position Applying For: *Employment EligibilityAre you a U.S. citizen? *Yes*No*If No, are you allowed to work in the U.S?YesNoHave you ever worked for this West End? **YesNo*If Yes, write the start and end dates.Have you ever been convicted of a felony? **YesNo*If Yes, please explain.EducationHigh School *City/State *Years AttendedDid you graduate? *YesNoIf you have not graduated, what year of high school are you in?CollegeCity/StateYears AttendedDid you graduate?YesNoIf you have not graduated, what year of college are you in?DegreeEmployment HistoryThis is my first job.Employer #1Email AddressPhoneStreet AddressApartment, suite, etcCityStateZIPJob TitleResponsibilitiesStarting DateEnding DateReason for LeavingEmployer #2Email AddressPhoneStreet AddressApartment, suite, etcCityStateZIPJob TitleResponsibilitiesStarting DateEnd DateReason for LeavingEmployer #3Email AddressPhoneStreet AddressApartment, suite, etcCityStateZIPJob TitleResponsibilitiesStarting DateEnd DateReason for LeavingReferencesReference #1RelationshipCompanyTitleEmail AddressPhoneReference #2Reference #2RelationshipCompanyTitleEmail AddressPhoneReference #3Reference #3RelationshipCompanyTitleEmail AddressPhoneMilitary ServiceAre you a veteran?YesNoBranchRank at DischargeStarting DateEnding DateType of DischargeIf not honorable, please explain:Background Check ConsentIf asked, are you willing to consent to a background check? *YesNoDisclaimerApplicant understands that this is an Equal Opportunity Employer and committed to excellence through diversity. To ensure this application is acceptable, please print or type with the application being fully completed for it to be considered.Consent *I, the Applicant, certify that my answers are true and honest to the best of my knowledge.  If this application leads to my eventual employment, I understand that any false or misleading information in my application or interview may result in my employment being terminated. I hereby certify that the information set forth in the above application is true and accurate to the best of my knowledge and belief, and I authorize West End House Camp, or its partners to verify such and obtain references who may attest to such.  I hereby release West End House Camp from all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based upon such information.  I understand that, if employed, falsified statements of any kind or omissions of facts from this application shall be considered sufficient basis for dismissal. I further understand that this application or the interview process shall not be deemed to constitute the terms of an implied employment contract. West End House Camp reserves the right to request a new application after 30 days from the date indicated below.Signature *Start signing your signature hereYour browser does not support e-Signature field.Type NameDate *Send Message Share this:FacebookTwitterEmail
