Communities In Schools of the Gulf South, Inc. Employment Application

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CIS requires a cover letter and resume in addition to this completed application. Please send an email with your cover letter and resume to employment@cisgulfsouth.org. CIS is unable to move forward with any applicant until we have received an application, cover letter, and resume. Thank you in advance for your attention to this matter.

We offer equal employment opportunity to all based upon individual merit and without regard to race, color, religion, national origin, gender, sexual orientation, gender identity, age, height, weight, marital status, or disability, which, if needing accommodation because of physical disability, may be reasonably accommodated as required by law.

Last Name, First Name, Middle Initial *

Date *

YYYY

Primary Phone Number *

Secondary Phone Number

Email Address *

Current Home Address *

Previous Home Address *

Position Applying For *

How did you learn about Communities In Schools Gulf South? *

Are you authorized to work in the United States on a full-time basis? *

Yes

Are you currently employed? *

Yes

Were you in the U.S. Military? *

Yes

If Yes, please list dates of service and brief description of your duties.

Have you been convicted of a felony? *

Yes

If Yes, please explain.

Education & Training - High School *

Please List: Name & Location of School, Type of Degree or Diploma Earned, and Field of Study (if any).

Education & Training - Undergraduate/College *

Please List: Name & Location of School, Type of Degree or Diploma Earned, and Field of Study (if any).

Education & Training - Graduate School *

Please List: Name & Location of School, Type of Degree or Diploma Earned, and Field of Study (if any).

Education & Training - Additional College/University

Please List: Name & Location of School, Type of Degree or Diploma Earned, and Field of Study (if any).

Are you currently Licensed, Registered, or Certified to work in the State of Louisiana? *

Yes

If Yes, please provide the Type of License or Certification, License or Certification Number, and Expiration Date

List multiple if necessary

Describe any Specialized Training, Knowledge, Skills, and Extracurricular Activities. *

If you are Bilingual, list languages in which you are proficient.

Experience Level - Microsoft Word *

No Experience

Knowledgeable

Highly Knowledgeable

Experience Level - Microsoft Excel *

No Experience

Knowledgeable

Highly Knowledgeable

Experience Level - Microsoft PowerPoint *

No Experience

Knowledgeable

Highly Knowledgeable

Employment Experience #1

Most Recent

Name of Employer *

Address of Employer *

Phone Number of Employer *

Job Title *

Dates Employed *

Starting and Final Salary *

Direct Supervisor *

Job Duties *

Reason For Leaving *

Employment Experience #2

Name of Employer *

Address of Employer *

Phone Number of Employer *

Job Title *

Dates Employed *

Starting and Final Salary *

Direct Supervisor *

Job Duties *

Reason For Leaving *

Employment Experience #3

Name of Employer

Address of Employer

Phone Number of Employer

Job Title

Dates Employed

Starting and Final Salary

Direct Supervisor

Job Duties

Reason For Leaving

Professional Reference #1

Not related to you and other than supervisors previously listed on this application

Reference Name *

Reference Phone Number *

Reference Email Address *

Relationship to Applicant *

Professional Reference #2

Not related to you and other than supervisors previously listed on this application

Reference Name *

Reference Phone Number *

Reference Email Address *

Relationship to Applicant *

Professional Reference #3

Not related to you and other than supervisors previously listed on this application

Reference Name *

Reference Phone Number *

Reference Email Address *

Relationship to Applicant *

May we contact your present and past employers for a reference? *

Yes

If you have been employed under a different name, please specify.

I Understand

By selecting "Agree" below, I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option, I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than its president, and only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing. I understand that any offer of employment I may receive from Communities In Schools Gulf South is contingent upon the organization's pre-employment screening process, including the organization receiving references that it considers satisfactory. I understand that as a condition of employment I will be required to undergo and successfully pass a criminal background check and that drug testing may be required. I also authorize Communities In Schools Gulf South to contact present and former employers that I have listed as references about my employment record. *

I Agree

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