Application for Employment

PERSONAL INFORMATION

Name

First

Middle

Last

Address

Telephone no.

City

State

ZIP

POSITION APPLYING FOR

Job Title Job Title

Available Start Date

Minimum Acceptable Salary

Are you legally eligible to work in the United States? (Federal Law requires proof of identity and employment authorization for all new employees.)

Can you travel if the job requires it?

Do you have a valid driver’s license?

State

EDUCATION/TRAINING

High School Information

Name (High School)

Location (High School)

Date attended from (High School)

Date attended to (High School)

Graduated?

College Information

Name (College)

Location (College)

Date attended from (College)

Date attended to (College)

Graduated?

Other (Business, Vocational, Military)

Name (Business, Vocational, Military)

Location (Business, Vocational, Military))

Date attended from (Others)

Date attended to (Others)

Graduated?

EMPLOYMENT HISTORY (Please Start With the Most Recent)

Employer-1

Address (Emp-1)

Telephone no (Emp-1)

Supervisor Name

Date From

Date To

Final rate of pay

Position held (Emp-1)

Primary duties (Emp-1)

Reason of leaving (Emp-1)

Next Employer (Emp-2)

Employer-2

Address (Emp-2)

Telephone no (Emp-2)

Supervisor Name (Emp-2)

Date From (Emp-2)

Date to (Emp-2)

Final rate of pay (Emp-2)

Position held (Emp-2)

Primary duties (Emp-2)

Reason of leaving (Emp-2)

Next Employer (Emp-3)

Employer-3

Address (Emp-3)

Telephone no (Emp-3)

Supervisor Name (Emp-3)

Date From (Emp-3)

Date to (Emp-3)

Final rate of pay (Emp-3)

Position held (Emp-3)

Primary duties (Emp-3)

Reason of leaving (Emp-3)

Next Employer (Emp-4)

Employer-4

Address (Emp-4)

Telephone no (Emp-4)

Supervisor Name (Emp-4)

Date From (Emp-4)

Date to (Emp-4)

Final rate of pay (Emp-4)

Position held (Emp-4)

Primary duties (Emp-4)

Reason of leaving (Emp-4)

TECHNOLOGY SKILLS (List All Skills & Software Applications You Have Experience Using):

Word processing:

Yes

Spreadsheet:

Yes

Database:

Yes

Microsoft Office:

Yes

PowerPoint:

Yes

Scanner:

Yes

Copier:

Yes

Digital Phone Systems:

Yes

Explain Internet Skills, Including Email Usage:

Describe your other software/technology skills (if any):

Professional Licenses or Certificates Held:

PERSONAL REFERENCES (Please list the names of three (3) persons not related to you by blood or marriage.)

Name (Ref-1)

First

Middle

Last

Address (Ref-1)

Telephone (Home)

Telephone (Others)

Connection To You (i.e. friend, co-worker):

Occupation (Ref-1):

Personal Reference (Ref-2)

Name (Ref-2)

First

Middle

Last

Address (Ref-2)

Telephone (Home)

Telephone (Others)

Connection To You (i.e. friend, co-worker):

Occupation (Ref-2):

Personal Reference (Ref-3)

Name (Ref-3)

First

Middle

Last

Address (Ref-3)

Telephone (Home)

Telephone (Others)

Connection To You (i.e. friend, co-worker):

Occupation (Ref-3):

OTHER DETAILS

If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?

Yes

Are you able to perform the essential functions of the job for which you are

Yes

If no, describe the functions that cannot be performed.

Have you ever been arrested or convicted of a criminal offense (felony or misdemeanor)?

Yes

If yes, please describe the criminal offense and the court’s disposition:

(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)

Acknowledgement – Please read before signing

A photocopy of official transcripts of all college/university course work must be filed in Human Resources with the
application. At the time of hire, official, original transcripts will be required.
A Criminal History Check form must be completed with the online application.
At the time of hire, a copy of driver's license and Social Security card must be filed for payroll purposes only.
An Employment Eligibility Verification (Form I-9) must be completed at the time of hire (Original documents only).
In order to receive credit for prior years of service, the applicant must obtain official service records from each school district where previously employed.
Professionals recommended for employment after January 1, 2008 will be required to submit to a national fingerprint criminal background check. The applicant is responsible for fees of approximately $50. Applicant will not begin work until fingerprints have been cleared.

On the first day of employment, I agree to furnish Instant Impact Global Prep with proof of age, appropriate academic credentials, military separation papers, professional certifications, and other such documents as may be required.

I hereby authorize Instant Impact Global Prep and/or its designee’s permission and authority to conduct a background investigation and reference checks concerning my past and current activities. I agree and consent to any investigation Instant Impact Global Prep and/or its designees may make, including but not limited to, information as to my personal character, general
reputation, former employment, education, criminal history, and any other information contained in public records or obtainable from former employers or references, personal or business.

Date

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Instant Impact Global Prep

PERSONAL INFORMATION

POSITION APPLYING FOR

EDUCATION/TRAINING

EMPLOYMENT HISTORY (Please Start With the Most Recent)

TECHNOLOGY SKILLS (List All Skills & Software Applications You Have Experience Using):

PERSONAL REFERENCES (Please list the names of three (3) persons not related to you by blood or marriage.)

OTHER DETAILS

Acknowledgement – Please read before signing

Instant Impact Global Prep

Instant Impact Global Preparatory Charter School (IIGP)

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