Apply Please enable JavaScript in your browser to complete this form. – Step 1 of 4Name *FirstLastEmail *SignatureClear SignaturePhone *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHow did you find out about this position?Current EmployeeCareer FairNewspaper AdRadio/TV ADSearch EngineSocial MediaCraigslistOtherIf otherPosition(s) applied for:Are you at least 18 years old?YesNoAre you legally eligible for employment in this country?YesNoHave you ever been employed here before?YesNoPosition:From:To:A record of criminal conviction will not necessarily be a bar to employment, since the Company will consider factors such as the position for which you are applying, the age and time of the offense, when it occurred, the nature and seriousness of the violation, and the evidence of rehabilitation in making any employment decision Have you ever pled no contest, nolo contendere, or guilty to a crime, or been convicted of a crime (other than minor traffic violations or matters that have been expunged or sealed) ?YesNoIf your answer is yes please explain:Availability (Can select more than one)Full TimeFull TimePart TimeTemporarySeasonalEducational/ Co-Op/ Internship1st Shift2nd Shift3rd ShiftWeekends OnlyAfter reading the job description, including the essential functions, are you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)? This question is not designed to elicit information about an applicant's disability Please do NOT provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary These issues may be addressed at a later stage to the extent permitted by lawYesNoDo you need more information about the job's " essential functions ” to respond ?YesNoUpload your resume Click or drag a file to this area to upload. Upload a cover letter Click or drag a file to this area to upload. Additional InformationNextEmployer:PhoneJob Title:Start Date:Finish Date:Name of Supervisor:FirstLastMay we contact for a reference:YesNoSummarize type of work performed:Why did you leave:Please summarize any special training, skills, licenses and / or certificates that may assist you in performing the on for which you are applying:What interested you in working for The Society ?NextCompleted GED CertificationMajor/ MinorDiploma Degree Other:NextName *FirstLastPhoneEmail *Relationship to you:Number of yearsAPPLICANT STATEMENTS I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview I hereby waive any and all rights and claims that I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non – defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law I understand that this application remains current for only 30 days At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law This application does not constitute an agreement or contract for employment for any specified period or definite duration I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the executive director I understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an 1-9 Form in this regard This company does not tolerate unlawful discrimination in its employment practices No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her sex, race, color, religion, sexual orientation, gender identity, national origin, ancestry, citizenship, age, disability, genetic information, veteran status, military status, or any other protected status under applicable federal, state or local law This company likewise does not tolerate harassment based on sex, race, color, religion, sexual orientation, gender identity, national origin, citizenship, ancestry, age, disability, genetic information, veteran status, military status, or any other protected status The company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to eliminate me from further consideration for employment, or may result in my immediate discharge from the employer's service, whenever it is discovered DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENTS I certify that I have read, fully understand and accept all terms of the foregoing Applicant StatementsAcceptDeclineSignatureClear SignaturePrinted Name:Date:CommentSubmit