arc

Activities

Job Application

Name
Address
City, State, Zip
Phone
Referred By

Position Applying For
Start Date
Full Time Part Time
Specify Hours
Salary Desired

Is there any reason we may not inquire of your present employer or prior employers? If yes, please explain below:

Have you ever applied to this company before?
If Yes, When and Where
Are you willing to work overtime?

If driving is a requirement of the job for which you are applying, do you have a valid driver's license? yes no
If you are a minor, can you produce the work certificate necessary to obtain employment? yes no
Are you able, at the time of employement, to submit verification of your legal right to work in the U.S. (verification and completion of form 1-9 must be submitted no later than 3 business days from date of hire.) yes no


Educational Background
High School Name
Location of School
Highest Grade Completed
Major Area of Study

College
Location of School
Highest Grade Completed
Major Area of Study

Trade, Business or Graduate School
Location of School
Highest Grade Completed
Major Area of Study

Specialized Skills

Certifications / Trainings (Effective/Expiration Dates)

Work Experience
Please list your last three employers, starting with present or last place of employment. You may include any verifiable work performed on a volunteer basis, internships or military service.
Employer
Start Date End Date
Address and Phone
Salary
Position
Supervisor
Reason for leaving

Employer
Start Date End Date
Address and Phone
Salary
Position
Supervisor
Reason for leaving

Employer
Start Date End Date
Address and Phone
Salary
Position
Supervisor
Reason for leaving

References
Name and Position
Company
Phone

Name and Position
Company
Phone

Name and Position
Company
Phone

Applicant Certification - Please Read Carefully
I understand that this application is not a contract, offer, or promise of employment. I acknowledge that employment with the company is on an employement at will basis. This means that my employement with the company can be terminated at any time, with or without cause or advance notice and acceptance of employment is not a contract of employment for any specified time. Similarly I am free to terminate my employment with the company at any time for any reason. This at-will provision may be modified or waived only in a written agreement signed by the company's president and me.

I further understand that I am responsible for being familiar with the Company's policies, rules and regulations and I understand that the company has complete discretion to modify its policies, rules, regulations and practices at any time, to the extent permitted by federal, state and local law, except that it will not modify its policy of employment at will. By my continued employment with the company, I consent to such changes.

I certify that the above information is complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation or omission of information on this form or relating to my application of employment may result in my denial of employment, or if employed, my immediate dismissal.

I hereby authorize the company or its agents to confirm all statements contained in this application and/or resume to the extent permitted by federal, state or local law and i agree to complete any requisite authorization forms (federal law requires a seperate release form when obtaining Consumer Credit Reports.) I release all parties from any liability arising out of this provision and the use of such information.

Please note that upon an accepted offer of employment The Arc of Northern Bristol County d/b/a proAbility will conduct both a CORI and BCI background check.


I have read and understand the above.



Success Stories

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We are a local affiliate of a state-wide and national advocacy organization formed in 1959 by a small group of parents concerned about the quality of life for their family members with disabilities. The Arc services are flexible and varied to meet each individual's and families needs. Please feel free to visit our Services directory above for more specifics on the type and scope of services we offer.