The Vista School® - Employment Application Form
|
| Position Applied For
*
|
|
|
| If other
|
|
|
Personal Information
|
| Name
*
|
|
|
| Prefix
|
|
|
| First
*
|
|
|
| Last
*
|
|
|
| Suffix
|
|
|
| Address
*
|
|
|
| Street Address
*
|
|
|
| Address Line 2
|
|
|
| City
*
|
|
|
| State / Province / Region
*
|
|
|
| Postal / Zip Code
*
|
|
|
| Country
*
|
|
|
| Home Phone
*
|
|
|
| Work / Cell Phone
|
|
|
| Email Address
|
|
|
| Confirm Email
|
|
| Social Security Number
|
Note: completion of SS# is optional. Failure to submit your social security number on this form will not prohibit employment consideration. Your Social security number may be required on other forms prior to employment.
|
| If hired, can you provide proof of citizenship or legal right to work in the United States?
*
|
Yes No
|
EDUCATION:
|
| Name / Location of School, Dates Attended, Subject (Major/Minor), # of Credits, Degree Received (Date) - (Please include both undergraduate and graduate)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| If you expect to complete an educational program in the near future, please indicate what type of degree or program and expected completion date:
|
|
|
| What additional training and/or education have you had that would be relevant to the position you are applying for?
|
|
|
| Please list any social and professional organizations to which you belong:
|
|
|
EMPLOYMENT HISTORY:
Present Or Last Position:
|
| Employer:
*
|
|
|
| Address:
*
|
|
|
| Supervisor:
*
|
|
|
| Phone Number
*
|
|
|
| Email
|
|
|
| Position Title:
*
|
|
|
| Start Date
*
|
|
|
| End Date
*
|
|
|
| Responsibilities:
*
|
|
|
| Salary
*
|
Input hourly wage, if not salaried.
|
| Reason for Leaving:
*
|
|
|
Previous Position
|
| Employer:
*
|
|
|
| Address:
*
|
|
|
| Supervisor:
*
|
|
|
| Phone Number
*
|
|
|
| Email
|
|
|
| Position Title:
*
|
|
|
| Start Date
*
|
|
|
| End Date
*
|
|
|
| Responsibilities:
*
|
|
|
| Salary
*
|
Input hourly wage, if not salaried.
|
| Reason for Leaving:
*
|
|
|
Previous Position
|
| Employer:
*
|
|
|
| Address:
*
|
|
|
| Supervisor:
*
|
|
|
| Phone Number
*
|
|
|
| Email
|
|
|
| Position Title:
*
|
|
|
| Start Date
*
|
|
|
| End Date
*
|
|
|
| Responsibilities:
*
|
|
|
| Salary
*
|
Input hourly wage, if not salaried.
|
| Reason for Leaving:
*
|
|
|
| Please explain periods of unemployment:
|
|
|
| Have you ever been discharged from a position or forced to resign?
|
Yes No
|
| If yes, please explain:
|
|
|
| Do you object to having any of your employers, including your present employer, contacted in regard to your qualifications, character, etc.?
|
Yes No
|
| If yes, please explain:
|
|
|
| Have you ever been arrested, indicated, or summoned into court as a defendant in a criminal proceeding, or been convicted, fined, imprisoned, placed on probation/parole, had adjudication withheld, pleaded nolo contender, or ordered to deposit bail for the
|
Yes No
|
| If yes, please explain:
|
|
|
References:
Name/Title / Address / Phone
*
|
|
|
|
|
|
|
|
|
|
|
| Upload your current resume
*
|
|
|
| Upload an optional cover letter
|
|
|
| What date are you available to start work?
*
|
|
|
| Expected beginning salary
|
|
|
Application Certification
|
I hereby certify that all entries on this application are true and complete, and I agree
and understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part of any employment within The Vista School. I understand that all information on this application is subject to verification and I consent to criminal history background checks. I also consent you to contact my references, former employers and educational institutions listed regarding this application. I further understand that all employees of The Vista School are employees at-will. Either you or The Vista School may terminate your employment at any time, for any reason, with or without cause.
|
| Do you agree with the terms and conditions?
*
|
Yes, I agree.
|
| Initial
*
|
|
|
| Certification Date
*
|
|
|
|
Image Verification
|
|
|
|
|
|