Applicant Information Date
First Name
Middle Name
Last Name
Street Address
Apt / Unit #
City
State
Zip Code
Phone Number
Email Address
Dates Available
Position Applied For
If yes, when?
If yes, what is the name of the employee who referred you?
Education & Permits High School
Address
Date From
Date To
Diploma
College
Address
Date From
Date To
Degree
Other Education
Address
Date From
Date To
Degree
If yes, which languages?
Check which Child Development Permit you currently possess: Teacher Assistant Permit Associate Teacher Permit Teacher Permit Master Teacher Permit Site Supervisor Permit Program Director Permit
Previous Employment Company
Phone
Address
Supervisor
Job Title
Date From
Date To
Responsibilities
Reason for leaving?
Company
Phone
Address
Supervisor
Job Title
Date From
Date To
Responsibilities
Reason for leaving?
Company
Phone
Address
Supervisor
Job Title
Date From
Date To
Responsibilities
Reason for leaving?
References Please list three professional references.
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Disclaimer and Signature I certify that my answers are true and complete to the best of my knowledge.
Digital Signature
Date
Applicant's Statement Please read and initial each paragraph and sign application upon completion
I hereby authorize Mexican American Opportunity Foundation Mexican American Opportunity Foundation
Initial
I understand that if offered employment, the offer may be contingent on my passing a pre-employment alcohol and drug screen and a pre-employment physical. By signing this application, voluntarily agree to submit to a pre-employment alcohol/drug screen and pre-employment physical upon request. I understand that failure to pass the alcohol/drug screen and or physical will result in withdrawal of the employment offer. I also understand that refusal to submit to an alcohol/drug screen will be considered a voluntary resignation of employment.
Initial
I understand that nothing contained in the application or conveyed to me during any interview, which may be granted, is intended to create an employment contract, implied or explicit, between me and the Mexican American Opportunity Foundation Mexican American Opportunity Foundation Mexican American Opportunity Foundation Mexican American Opportunity Foundation
Initial
I understand and agree that any future changes in my title, duties, compensation, working conditions, and/or Mexican American Opportunity Foundation
Initial
I understand that if offered employment, I will, as a condition of employment, be required to submit proof of my identity and legal right to work in the United States on my first day of employment.
Initial
If the position applied for requires driving in the course of work, understand that will be required to posses a current valid California Driver's License and understand that I will be required to provide a copy of my official driving record and proof of insurance. also understand that any offer of employment is contingent on my ability to be covered by Mexican American Opportunity Foundation
Initial
I hereby certify that have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. understand that any omission or misstatement on this application or on any documents used to secure employment shall be grounds for rejection or this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
Initial
My signature below certifies that I have read and understand this complete page, and agree to the terms and conditions outlined in this document.
Initial
Applicant's Digital Signature
Date
Voluntary EEO Identification Various Agencies of the United States Government require employers to maintain information on applicants pertaining to factors such as race, sex and type of position for which and individual applies. The information requested on this sheet is for compliance with certain records keeping requirements. MAOF believes all persons are entitled to equal employment opportunities, and does not discriminate against employees or applicants for employment because of race, color, religion, sex, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, marital status, pregnancy, sexual orientation, or any other basis prohibited by statue.
Name
Date
Position Applied For
Race/Ethnic Data: White (Non-Hispanic) Black (Non-Hispanic) Asian or Pacific Islander Hispanic American Indian or Alaskan Native
Regulations issued by the U.S. Department of Labor with respect of disabled individuals, disabled veterans, and Vietnam Era veterans require that federal contractors provide an opportunity for self-identification to candidates seeking employment. Such self-identification is submitted on a voluntary basis, on a confidential basis, for use only in accordance with regulations, and without subjecting the individual to adverse treatment.
Disabled/Veteran Classification(s): Disabled Person Vietnam Era Veteran Special Disabled Veteran
Explanation of Categories: White (Non-Hispanic origin) : Persons having origins any of the original peoples of Europe, North Africa or the Middle East.
