Employment Application

Non-Discrimination Policy: AVYFS and Affiliates is committed to the principle of equal opportunity in employment.  We do not discriminate on the basis of sex, race, color, creed, national origin, age, religion, sexual orientation, gender identity, gender expression, veteran status, or disability in admission to, access to, treatment in, or employment in its programs and activities.

 
A Village youth & Family Services is an Equal Opportunity Educational Institution and EEO/Affirmative Action Employer committed to excellence through diversity. Employment offers are made on the basis of qualifications and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation. Complete the entire application. You may have a resume, but you must still complete all questions; or your application will be deemed incomplete and may not be considered. Please fill out each box (do not indicate “See Resume.”) Applications with missing or invalid job numbers will not be considered for any position.
Name *
Name
Address
Address
Position Applying for:
Location *
Referral Source:
Date of Birth *
Date of Birth
Are you 18 years of age or older? *
Have you ever filed an application here before? *
Have you ever been employed here? *
Are you currently employed? *
If yes may we contact your employer? *
if hired are you legally eligible for employment in the United States? (Proof of legal work status will be required upon employment) *
Employment desired: *
Shifts available to work: (For Residential Crisis Stabilization applicants ONLY)
Education
School Name & Address *
School Name & Address
Status *
Type of Degree *
School Name & Address
School Name & Address
Status
Type of Degree
School Name & Address
School Name & Address
Status
Type of Degree
Work Expereince
Please list your work experience beginning with your most recent job. If you were self-employed, give firm name. Attach additional sheets if necessary. Exclude organization names which indicate race, color, creed, national origin, age, religion, sexual orientation, gender identity, gender expression, veteran status, or disability.
Address *
Address
Start date *
Start date
End date
End date
$
Address *
Address
Start date *
Start date
End date
End date
$
Address *
Address
Start date *
Start date
End date
End date
$
I certify that the information on this application is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize A Village youth & Family Services to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of A Village youth & Family Services serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. I understand that the first 90 days of regular employment represent a provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.
I have read and agree/consent with the above statement *
Signature: *
Signature:
Application date *
Application date