Application for Employment Note: Required fields have a red asterisk (*) in front.
*First Name:		*Last Name:
*Street Address:		Apartment:
*City:		*State:	Choose a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
*Zip Code:		*Phone Number:
Sender Email:
If employed and you are under 18, can you furnish a work permit?  Yes     No  Note: Proof os U.S. Citizenship or valid immigration status will be required prior to the commencement of your employment.
*Position(s) applying for:		*Min Salary Req $:	Please Select 15,000 - 20,000 21,000 - 25,000 26,000 - 30,000 31,000 - 33,000 34,000 - 37,000 38,000 - 40,000 40 and above
Date you can start:
Areas of interest:	Food Service / Maintenance   Clerical   Residential   Finance   Development   Day Care   Case Management
*Availability (please select all that apply):	Full-time   Part-time   Relief / On-Call   Mornings   Afternoons   Evenings   Overnight   Weekends / Holidays
*Do you understand the job requirements of the position that you applied for?			Yes     No
*Can you perform the requirements of this job with or without a reasonable accommodation?			Yes     No
*Have you ever worked for The Salvation Army?			Yes     No
If yes, when and where?:
*Referral Source:	Advertisement   Website   Employment Agency   Walk-In   Friend / Relative   Other
Employment History
Provide the following information for your past two (2) employers, assignments or volunteer activities starting with the most recent.
Job 1
*Job Title:		*Supervisor Name and Title:
*From:		*To:
*Employer:		Address:
City:		State:	Choose a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
Zip:		Telephone:
Job Responsibilities:
Reason for Leaving:
Salary Start:		Salary End:
Job 2
*Job Title:		*Supervisor Name and Title:
*From:		*To:
*Employer:		Address:
City:		State:	Choose a state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington Washington, D.C. West Virginia Wisconsin Wyoming
Zip:		Telephone:
Job Responsibilities:
Reason for Leaving:
Salary Start:		Salary End:
Skills and Qualifications
*Summarize any training, skills, licenses and/or certificates that may relate to position(s) applied for:
Educational Background
*Degrees (select all that apply):	AAS / AS   BA / BS   BSW   MA / MS   MSW   Technical / Business   High School   GED   Other
References - Professional
List the name, address, relationship and telephone number of two (2) professional references who can verify your employment history, work record and qualifications.
Professional Reference 1
*Name and Address:
*Relationship:		*Telephone:
Professional Reference 2
*Name and Address:
*Relationship:		*Telephone:
References - Personal
List the name, address, relationship and telephone number of three (3) personal references, other than relative, who can attest to your character, reputation and personal qualifications.
Personal Reference 1
*Name and Address:
*Relationship:		*Telephone:
Personal Reference 2
Name and Address:
Relationship:		Telephone:
Personal Reference 3
Name and Address:
Relationship:		Telephone:
I certify that the answers given herein are true and complete to the lest of my knowledge and understand that, if employed, falsified or misleading information given in my application, interview(s), or any related employment paperwork may result in discharge. I authorize the investigation of all statements contained herein and the references listed above to give you any and all information they have, personal and otherwise, and release all parties from liabaility for any damage that may result from furnishing same to The Salvation Army. I understand that all positions will require screening by inquiring from the State Central (Child Abuse) Registry as to whether or not I am the subject of a previous incident of indicated child abuse, neglect or maltreatment, as well as a criminal records check. I undertand that in the event of employment I am required to abide by the personnel policies and practices as outlines in the Employee Manual. I understand that, if hired, my employment is for no definite period and may be terminated at any time and without prior notice; also that The Salvation Army is an at-will employer.
*I agree.