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Page 1

Applicant Information

First Name

Last Name

Address Line 1

Address Line 2

City

Country

State/Province

Postal Code

Birth date (MM/DD/YYYY)

Phone

Date Available:

Position(s) I am interested in:

If you don't have a specific position in mind, state you are willing to consider any open position.

Desired Salary:

Are you applying with the intent to raise personal financial support for your position? (Note: Training and resources are available to help in the fundraising process.)

Have you ever been convicted of a felony?

YesNo

If yes, please explain:

How did you hear about R CITY?

Education & References (Leave sections blank that do not apply to you.)

Educational Information and Military Service:

I have included this information on my resumeThere is an option to upload your resume on page 4. If you have already submitted your resume through an online job site (like Indeed) you do not need to submit it again.

High School

Name of high school

Address

Start: (Year)

End: (Year)

Did you graduate?

YesNo

College

Name of college

Address

Start: (Year)

End: (Year)

Did you graduate?

YesNo

Degree:

Other

Name of school

Address

Start: (Year)

End: (Year)

Did you graduate?

YesNo

Degree/Certification:

Military Service

Branch:

Start: (Year)

End: (Year)

Rank at Discharge:

Type of Discharge

If other than honorable, explain:

References

Please list at least one professional reference or personal references. This is mandatory for any of our staff who will be working with children.

Professional References

I have included references on my resume.There is an option to upload your resume on page 4. If you have already submitted your resume through an online job site (like Indeed) you do not need to submit it again.

Reference One

Name

Relationship

Phone number

Company

Company Address

Reference Two

Name

Relationship

Phone number

Company

Company Address

Reference Three

Name

Relationship

Phone number

Company

Company Address

Previous Employment

Information on previous employment:

I have included this information on my resumeThere is an option to upload your resume on the bottom of this page. If you have already submitted your resume through an online job site (like Indeed) you do not need to submit it again.

Company One

Company

Address

Phone

Job title

Supervisor

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for leaving

May we contact your previous employer for a reference?

YesNo

Company Two

Company

Address

Phone

Job title

Supervisor

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for leaving

May we contact your previous employer for a reference?

YesNo

Company Three

Company

Address

Phone

Job title

Supervisor

Starting Salary

Ending Salary

Responsibilities

From:

To:

Reason for leaving

May we contact your previous employer for a reference?

YesNo

Resume: Optional

You are welcome to upload your resume in a PDF format here.

Photo Release & Disclaimer

If I am hired for any position at R CITY, I give permission for any photos or video taken of me to be used for promotion and development of R CITY’s programs without compensation to me.

Yes, I give my permission.

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Yes, I understand.

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R CITY Employment Application

Page 1

Education & References (Leave sections blank that do not apply to you.)

References

Previous Employment

Resume: Optional

Photo Release & Disclaimer