Job Application – Building Bridges

Full Name*

Social Security Number*

Address*

Street Address City State ZIP Code

Email*

Telephone Number*

Message Number

Are you 18 years of age or older?*

Birth Date*

Do you have a valid driver's license?*

Driver's License State*

Driver's License Number*

Have you ever applied to, or worked for Building Bridges before?*

What Year?*

Do you have any friends or relatives working for Building Bridges?*

Please list their names and relationships*

How did you hear about us/this opening?*

Position you're applying for?*

Employment Level*

Other (please explain)*

Hourly rate of pay acceptable*

Date available for employment*

State briefly why you would like to work for Building Bridges.*

Have you in the last 10 years been convicted of a felony (excluding any sealed or expunged convictions)?*

NOTE:No applicant will be denied employment solely on the grounds of a conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.

Felony conviction – Please explain*

Education and Training

Check all that apply, and provide details below

High School

College / University

Trade / Vo Tech

Other Training

High School

High School Location / State*

High School Highest Grade Completed*

Diploma or GED?*

College/University

College/University Location / State*

College/University Highest Grade Completed*

College/University Degree?*

Trade / Vo Tech

Trade/Vo Tech Location / State*

Trade/Vo Tech Degree?*

Other Training

Other Training: Please provide details about location and type of training, as well as any certifications earned

Previous Employment

List below all previous employers starting with your present or most recent position (last 10 years is sufficient)

Previous Employment Entries

Name of Company	Name of Supervisor	Positions and Duties	Fulltime or Part-Time?	Actions

There are no Entries.

Personal References

Not former employer or relative

Reference 1 Name*

Reference 1 Phone*

Reference 2 Name*

Reference 2 Phone*

Consent

Please read and check each box below. If there is any part of the paragraph you do not understand, please ask the interviewer about it before submitting.

References*

I hereby authorize Building Bridges to thoroughly investigate my references, work records, education and other matters related to my suitability for employment and, further, authorize my current and former employers to disclose to the company any and all letters, reports, and other information pertaining to my employment with them, without giving me prior notice of such disclosure. In addition, I hereby release Building Bridges, my current and former employers, and all other persons, corporations, partnerships and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigations or disclosure.

Pre-Employment Alcohol & Drug Screening*

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, I voluntary agree to submit to a pre-employment drug screen and a pre-employment physical. I understand that failure to pass the alcohol/drug screen and/or physical will result in withdrawal of the employment offer.

Employment Alcohol & Drug Screening*

If hired, I also agree to submit to alcohol or drug testing as a condition of employment. I agree the Building Bridges may conduct alcohol or drug screening to its sole discretion with or without notice. I also understand that refusal to submit to an alcohol or drug screen will be considered a voluntary resignation of employment.

Employment Terms*

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 Building Bridges In addition, I understand and agree that if I am employed, my employment relationship with Buidling Bridges is strictly voluntary and at our mutual will. I understand that if employed, my employment is for no definite period and may be terminated at any time, with or without prior notice, with or without cause or reason, at the option of either myself or Building Bridges and that no promises or representations contrary to the forgoing are binding on Building Bridges unless made in writing and signed jointly by the Executive Director/CEO and myself.

Future Changes*

I understand and agree that any future changes in my title, duties, compensation, working conditions, and/or Building Bridges benefits, policies and procedures will not alter our at-willl and arbitration agreements.

Proof of Identity*

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.

Driving*

If the position applied for requires driving in the course of work, I understand that I will be required to possess a current and valid Arkansas driver’s license and understand that I will be required to provide a copy of my official driving record and proof of insurance. I also understand that any offer of employment is contingent on my ability to be covered by Building Bridge’s auto insurance, if required for my position.

Truthfulness of this information*

I hereby certify that I 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. I understand that any omission or misstatement on this application or on any documents used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

Signature*

My signature above certifies that I have read and understand this complete page, and agree to the terms and conditions outlined in this document.

Name

This field is for validation purposes and should be left unchanged.

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Employment Application

Education and Training

High School

College/University

Trade / Vo Tech

Other Training

Previous Employment

Personal References

Consent