Employment Application : About Us : Redwood Empire Food Bank

The Redwood Empire Food Bank is an equal opportunity employer. We do not discriminate in employment on account of race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service.

PERSONAL INFORMATION

Incomplete information could disqualify you from further consideration. Please complete all fields.

Date

Name

First Name *

Last Name *

Address

Country

Address Line 1 *

City *

State/Province *

Postal Code *

E-mail Address

Home Phone #

Mobile Phone #

Are you eligible to work in the U.S?

Are you fluent in English?

Are you fluent in Spanish?

Are you at least 18 years or older? (If no, you may be required to provide authorization to work.)

If hired, would you have a reliable means of transportation to and from work?

Have you ever been terminated from employment or asked to resign by an employer?

If yes, please provide company names and details

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Can you work overtime, including weekends?

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?

If no, describe the functions that cannot be performed:

(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applications/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

EMPLOYMENT DESIRED

Date you can start

Month

Day

Year

Hourly Rate/Salary desired

Position desired

Are you currently employed?

If so may we inquire of your present employer?

REFERRAL SOURCE

How did you hear about us?

Walk In
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Referral
Other

Have you visited our website?

Have you ever worked for this company before?

Do you know anyone who works for our company?

If yes, who?

We may refuse to hire relatives of present employees if doing so could result in actual or potential problems in supervision, security, safety, or morale, or if doing so could create conflicts of interest.

EDUCATION

Check if included on resume

High School

Name and location of school

No. of yrs. attended

Degree received

Subjects studied/Major

College or University

Name and location of school

No. of yrs. attended

Degree received

Subjects studied/Major

Trade, Business or Correspondence School

Name and location of school

No. of yrs. attended

Degree received

Subjects studied/Major

EMPLOYMENT HISTORY

Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration.

Check if included on resume

Employment 1

From / To

Start Date

–

End Date

Employer Name

Telephone

Address

Country

Address Line 1

City

State/Province

Postal Code

Job Title

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities

Reason for leaving

Employment 2

From / To

Start Date

–

End Date

Employer Name

Telephone

Address

Country

Address Line 1

City

State/Province

Postal Code

Job Title

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities

Reason for leaving

Employment 3

From / To

Start Date

–

End Date

Employer Name

Telephone

Address

Country

Address Line 1

City

State/Province

Postal Code

Job Title

Immediate supervisor and title

Summarize the nature of work performed and job responsibilities

Reason for leaving

Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for? If yes, explain.

Computer Skills (please describe):

REFERENCES

Give the names of three persons not related to you, whom you have known at least three (3) years.

Reference 1

Name

Phone or Email

Company

Years Acquainted

Reference 2

Name

Phone or Email

Company

Years Acquainted

Reference 3

Name

Phone or Email

Company

Years Acquainted

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Please read carefully before signing.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the Redwood Empire Food Bank to hire me. If I am hired, I understand that either the Redwood Empire Food Bank 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 Redwood Empire Food Bank has the authority to make any assurance to the contrary.

With my signature below, I have given to the Redwood Empire Food Bank true and complete information on this application. No requested information has been concealed. I authorize the Redwood Empire Food Bank to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Date

Signature

THIS APPLICATION IS VALID ONLY FOR 60 DAYS FROM THE DATE SIGNED/DATED ABOVE.