Equal Employment Opportunity Statement:
Employment decisions will be based on the principles of equal opportunity. All personnel actions (recruiting, hiring, training, promotion, compensation, etc.) are administered without regard to any characteristic protected by state, federal or local law, assuming said characteristic does not interfere with the performance of essential job functions. Reasonable accommodations will be made for disabilities and religious beliefs. Please inform us of any necessary accommodations to the application process.
Time Availability (Required) Days Available (Required) Hours Available: (Required) Your Information Your Name (Required)
(Required) Previous Address
Project Independence Employment Have you ever worked for Project Independence before? (Required) If Yes, please give dates and position Employment Information
Please list employment starting with your most recent position. Account for any time during this period in which you
were unemployed or military service by stating the nature of your activities. If self-employed, give firm name and
supply business references.
Employment Job Address
(Required) Job Title & Duites (Required) Yes Add More Employment Job Address 2
Yes Add More 2 Employment Job Address 3
Yes Add More 3 Employment Job Address 4
Are you legally eligible for employment in the United States? (Proof of eligibility required upon employment) (Required) Are you a veteran? (Required) Have you ever been terminated or asked to resign from any job? (Required) Please explain fully, any gaps in your employment history: (Required) May we contact your current employer? (Required) Please indicate any actual experience, special training and qualifications that you have which you feel are relevant to the position for which you are applying. (Required) Have you ever used another name? (Required)
Is there any additional information relative to change of name. Use of an assumed name, or nickname necessary to
enable a check on your work and educational records?
If hired, can you furnish proof that you are 18 years of age? (Required) Other Information Do you have First Aid Certification? (Required) Do you have CPR certification? (Required) Do you have a valid California Driver’s License? (Required) Do you have valid automobile insurance? (Required) Do you have a working car to carry out specific duties? (Required) Do you have adequate transportation to and from work? (Required) Are you capable of satisfactorily performing the essential job duties required of the position for which you are applying? (Required) Education Years Completed (Required) Select One 4 5 6 7 8 Diploma Degree Years Completed 2 (Required) Select One 9 10 11 12 Diploma Degree 2 Years Completed 3 Select One 1 2 3 4 5 Diploma Degree 3 Years Completed 4 Select One 1 2 3 4 5 Diploma Degree 4 Personal References
Please list persons who know you well Ð not-previous employers or relatives.
THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF THIRTY
(30) DAYS, IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME,
YOU MUST REAPPLY. Please Read This Statement Carefully I Certify (Required) I Authorize (Required) If Hired (Required) I Understand (Required) I have read (Required) Conditions of Employment
The following are conditions of employment for all positions at Project Independence and the employee is responsible for any cost incurred in meeting these conditions prior to start date:
1. DMV Report - All applicants must provide a three year DMV report before their start date if hired. Failure to demonstrate a good driving record will result in disqualification of employment with our company.
2. Driver's License & Vehicle Insurance - Employees must provide a valid California Driver's License and valid auto insurance. These items must be kept current and will be reviewed at their expiration dates.
3. First Aid and CPR - Certification must be valid prior to first day of work. Failure to obtain certification will result in termination of employment.
4. Fingerprints - fingerprinting is required by the State of California.
5. Proof of Employment Eligibility (I-9) - The Department of Homeland Security requires that all employees submit proof of eligibility to work in the United States. A complete list of documents which may meet these requirements is on the back of the I-9 form.
6. Proof of High School Diploma and any advanced degrees.
7. A valid Social Security Card.
I Authorize Project (Required)