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Application for Employment
KY Emergency Housing
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Date
MM
/
DD
/
YYYY
Name
*
First
Your answer
*
Middle
Your answer
*
Last
Your answer
Mailing Address
*
Street Address
Your answer
Street Address 2
Your answer
*
City
Your answer
*
State
Your answer
*
Zip
Your answer
Best phone number to reach you:
*
Your answer
Email Address
*
Your answer
Driver's License Number
*
Your answer
Position Applying For
*
Your answer
Part-time
Full-time
Clear selection
Referred by:
Friend:
Your answer
Relative:
Your answer
Refuge for Women Staff Member:
Your answer
Other:
Your answer
When would you be available to start?
*
Other:
Your answer
If you are applying for a City Director or Development Director position, please send a video cover letter to
refugeweb@refugeforwomen.org
(Max file size 30 MB, does not need to be a professional video)
Are you legally eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment)
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Choose
Yes
No
Are you at least 18 years of age or older?
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Yes
No
Have you been convicted of a crime other than a minor traffic violation? (A conviction will not necessarily result in the denial of employment):
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Yes
No
If yes, please explain:
Your answer
Have you ever worked at Refuge for Women before?
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Yes
No
If yes, please provide details (where/when/job title):
Your answer
Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation?
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Yes
No
If no, please explain:
Your answer
Do you use social media?
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Yes
No
If yes, please provide us your Facebook, Twitter, and/or Instagram names:
Your answer
Office Skills
List software programs you have used and your competence with each:
Your answer
Additional Skills
Bookkeeping
ACT!
Other:
Education
High School
Name
Your answer
City/State
Your answer
*
Did you graduate?
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Yes
No
Describe any specialized training, apprenticeships, skills, honors and extra-curricular activities:
Your answer
College/University
Name
Your answer
City/State
Your answer
Years Complete
1
2
3
4
Diploma/Degree
Your answer
Course of Study
Your answer
Describe any specialized training, apprenticeships, skills, honors and extra-curricular activities:
Your answer
Graduate/Professional
Name
Your answer
City/State
Your answer
Years Completed
1
2
3
4
Diploma/Degree
Your answer
Course of Study
Your answer
Describe any specialized training, apprenticeships, skills, honors and extra-curricular activities:
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