Apply for Facility Assistant

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:	Facility Assistant
ID:	2029
Department:	Facility Staff
Contact Information
* First Name:
* Last Name:
Preferred or Nick Name:
* Date of Birth:
* Gender:
Preferred Pronouns:
* Email:
* Phone:
* Mailing Address Line 1 (Permanent address):
Mailing Address Line 2:
* City:
* State:
* Zip:

Facility

* Birthdate:

* How did you hear about Camp John Marc? Please be specific.

Upload Resume

* Please list previous facility experience:

Please list previous housekeeping experience:

Please list certification(s) you hold:

Education

* High School Attended:

* Date of High School Graduation:

College(s)/University Attended:

Major/Field of Study:

Current Year in College/University

Date of College/University Graduation

If you have not attended college, please share your comparable life experience:

Emergency Contact

* Emergency Contact Name (First and Last)

* Emergency Contact Phone

* Emergency Contact Relationship to You

Employment History

Please list any previous employment:

* Employer Name/Company #1

* Employer Phone number

* Nature of Work

* Dates Employed

* Reason for leaving

Employer Name/Company #2

Employer Phone number

Nature of Work

Dates Employed

Reason for leaving

Legal Information

* Please list all previous addresses since 18 years of age :

* Do you have a current, unrestricted driver's license?

	Yes
	No

If NO, please explain:

* Have you ever been fired and/or terminated from a job, or have you ever been suspended or required to withdraw from a school?

	Yes
	No

If YES, please explain:

* Have you ever been accused of, charged with, and/or convicted of any crime, including child molestation or crime endangering a child?

	Yes
	No

If YES, please explain:

* Have you ever been charged with a DUI and/or other motor offense?

	Yes
	No

If YES, please explain:

References

Please list the details of three (3) persons who have knowledge of your character, experience, and abilities. One reference must be a person of a different gender, one family member, and one professional. Please note, current contact information is required for all references, as references will be contacted as part of the hiring process.

* Name of Reference #1 DIFFERENT GENDER

* Reference #1 Phone Number

* Reference #1 Email

* Relationship to Applicant

* Name of Reference #2 FAMILY MEMBER

* Reference #2 Phone number

* Reference #2 Email

* Relationship to Applicant

* Name of Reference #3 PROFESSIONAL

* Reference #3 Phone number

* Reference #3 Email

* Relationship to Applicant

Authorization and Acknowledgement

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if my application for employment is accepted, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to accept my application. If I am approved for employment, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

* Signature:

* Today's Date:

I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.

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